Individual provider Active NPI

Allyn A Sison, RPT

  • Specialist
  • Glen Rock, NJ
National Provider Identifier
1659466241
Registry record updated Oct 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
40QA01137600 Issued in NJ
Practice address
266 Harristown Rd Ste 304
Glen Rock, NJ 07452-3321
Phone
(201) 857-0527
NPI assigned
Oct 3, 2006
Last updated
Oct 20, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 40QA01137600 NJ Primary

Addresses

Primary practice location

266 Harristown Rd Ste 304
Glen Rock, NJ 07452-3321

Mailing address

1175 Roosevelt Ave.
Carteret, NJ 07008-0536
Phone (732) 541-2233

Other practice location 1

1175 Roosevelt Ave.
Carteret, NJ 07008-0536
Phone (732) 541-2233

Other identifiers 1

IdentifierTypeStateIssuer
P00313564OtherNJRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050603000647 NJ Practitioner - Physical Therapist in Private Practice 3779526405 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sportsmed PT LLCGroup PAC ID 0749535805, 183 clinicians

Practice addresses (Care Compare)

1225 Stuyvesant Ave
Union, NJ 07083-3837
Phone (908) 357-1655

211 Berdan Ave
Wayne, NJ 07470-3236
Phone (201) 249-6930

266 Harristown Rd
Suite 200
Glen Rock, NJ 07452-3354
Phone (201) 445-7000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sportsmed PT LLC CurrentSince May 9, 2018 Accepting new patients
Prospect Medical PC Past Accepting new patients
Recover Pro Medical & Wellness Past Accepting new patients

Locations

266 Harristown Rd
Ste 304
Glen Rock, NJ 07452
Phone (201) 345-5905

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603152000000",
    "number": "1659466241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1175 ROOSEVELT AVE.",
            "city": "CARTERET",
            "state": "NJ",
            "postal_code": "070080536",
            "telephone_number": "732-541-2233",
            "fax_number": "732-541-2234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "266 HARRISTOWN RD STE 304",
            "city": "GLEN ROCK",
            "state": "NJ",
            "postal_code": "074523321",
            "telephone_number": "201-857-0527"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1175 Roosevelt Ave.",
            "address_purpose": "LOCATION",
            "city": "Carteret",
            "state": "NJ",
            "postal_code": "070080536",
            "country_code": "US",
            "telephone_number": "732-541-2233",
            "fax_number": "732-541-2234",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SISON",
        "first_name": "ALLYN",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "RPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NJ",
            "license": "40QA01137600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00313564",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Rock, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.