Individual provider Active NPI

Daniel Prata, PT, DPT, COMT

  • Physical Therapist
  • Clifton, NJ
National Provider Identifier
1669533501
Registry record updated Jun 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01212000 Issued in NJ
Practice address
1111 Clifton Ave
Suite 101
Clifton, NJ 07013-3633
Phone
(973) 400-3730
Fax
(973) 400-3731
NPI assigned
Dec 13, 2006
Last updated
Jun 6, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 40QA01212000 NJ Primary

Addresses

Primary practice location

1111 Clifton Ave
Suite 101
Clifton, NJ 07013-3633

Mailing address

1111 Clifton Ave
Suite 101
Clifton, NJ 07013-3633
Phone (973) 400-3730

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071124000001 NJ Practitioner - Physical Therapist in Private Practice 7810085081 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Forward Motion Physical Therapy LLCGroup PAC ID 1355497116, 5 clinicians
Forward Motion PT LLCGroup PAC ID 8022350297, 5 clinicians

Practice addresses (Care Compare)

1111 Clifton Ave
Suite 101
Clifton, NJ 07013-3633
Phone (973) 400-3730

167 Newark Pompton Tpke
Suite 101
Pequannock, NJ 07440-1340
Phone (973) 987-3310

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA01212000NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Forward Motion Physical Therapy LLC Physical Therapist CurrentSince Jul 20, 2009 Accepting new patients
Forward Motion PT, LLC Physical Therapist CurrentSince Jul 18, 2019 Accepting new patients
Damon Physical Therapy Physical Therapist Past Accepting new patients

Locations

1111 Clifton Ave
Ste 101
Clifton, NJ 07013
Phone (973) 400-3730

167 Newark Pompton Tpke
Ste 101
Pequannock, NJ 07440
Phone (973) 987-3310

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": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338940800000",
    "number": "1669533501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 CLIFTON AVE",
            "address_2": "SUITE 101",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070133633",
            "telephone_number": "973-400-3730",
            "fax_number": "973-400-3731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 CLIFTON AVE",
            "address_2": "SUITE 101",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070133633",
            "telephone_number": "973-400-3730",
            "fax_number": "973-400-3731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRATA",
        "first_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "PT, DPT, COMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2012-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01212000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2012; 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.