Brad Samples II, D.P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA01180900 Issued in NJ

Practice address

15 Corporate Drive
Unit 6
Wayne, NJ 07470

Phone

(973) 368-4907

Fax

(973) 368-4909

NPI assigned

Mar 12, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Performance Physical Therapy and Sports Conditioning LLCGroup PAC ID 6103098165, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Performance Physical Therapy & Sports Conditioning LLC

  • Physical Therapist
  • Wayne, NJ
  • NPI 1376763722

  NJ, Physical Therapist

  Medicare reassignment Care Compare group NPD Authorized official
• Performance PT LLC

  • Orthopedic Physical Therapist
  • Wayne, NJ
  • NPI 1003196213
  NPD (past) Authorized official
• Physical Therapy Associates of Wayne, Inc.

  • Physical Therapy Clinic/Center
  • Wayne, NJ
  • NPI 1992870802
  NPD (past)

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710979200000",
    "number": "1679605752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 HAMBURG TPKE STE E",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074706250",
            "telephone_number": "973-835-2827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 CORPORATE DRIVE",
            "address_2": "UNIT 6",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "07470",
            "telephone_number": "973-368-4907",
            "fax_number": "973-368-4909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMPLES",
        "first_name": "BRAD",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "credential": "D.P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-12",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01180900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexis Rae Saley, APN
• Carol Ann Salvatore, MSCCCSLP
• Nicole Michaela Salvemini
• Russell Samofal, D.P.M.
• Elkanah M Samoita
• Anish Samuel, MD
• Christian San Pedro, PT, DPT
• Deanna Marie Sanacore, APN
• Geraldine Sanchez-Marapao, PT
• Anthony Michael Sanchez, CCC-SLP

• All providers in Wayne, NJ
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2024; 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.