Individual provider Active NPI

Paul Neil Wiener, P.T.

  • Physical Therapist
  • Hackensack, NJ
National Provider Identifier
1689750069
Registry record updated Jan 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
QA4003741 Issued in NJ
Practice address
170 Prospect Ave Ste 2
Hackensack, NJ 07601-1834
Phone
(201) 880-8303
Fax
(201) 880-4893
NPI assigned
Oct 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 30, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 018834-1 NY
Physical Therapist 225100000X QA4003741 NJ Primary

Addresses

Primary practice location

170 Prospect Ave Ste 2
Hackensack, NJ 07601-1834

Mailing address

170 Prospect Ave
Apt 5L
Hackensack, NJ 07601-1858
Phone (201) 956-4188

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041022000901 NJ Practitioner - Physical Therapist in Private Practice 8426019431 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ivyrehab Network IncGroup PAC ID 3476539776, 658 clinicians

Practice addresses (Care Compare)

170 Prospect Ave
Suite 2
Hackensack, NJ 07601-1834

2 University PLZ
Unit 114
Hackensack, NJ 07601-6202
Phone (201) 488-0488

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
QA4003741NJMDPhysical Therapist
018834-1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ivyrehab Network, Inc. Physical Therapist CurrentSince Aug 1, 2025 Accepting new patients
Ivyrehab Network Inc. Physical Therapist CurrentSince Nov 16, 2019 Accepting new patients
Wienerphysicaltherapyservices Physical Therapist CurrentSince Aug 11, 2019 Accepting new patients
Ivyrehab Network Inc Physical Therapist CurrentSince Aug 1, 2025 Accepting new patients
James W Cahill MD LLC CurrentSince Aug 1, 2019 Accepting new patients
Orthopedic Specialist of New Jersey PA CurrentSince Aug 1, 2019 Accepting new patients

Locations

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

2 University Plz
Unit 114
Hackensack, NJ 07601
Phone (201) 488-0488

170 Prospect Ave
Ste 2
Hackensack, NJ 07601
Phone (201) 880-8303

87 Summit Ave
Hackensack, NJ 07601
Phone (201) 489-0022

454 Passaic St
Hackensack, NJ 07601
Phone (201) 488-7905

Organizations & group practices 7

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": "1161993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580342400000",
    "number": "1689750069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 PROSPECT AVE",
            "address_2": "APT 5L",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011858",
            "telephone_number": "201-956-4188",
            "fax_number": "201-956-4893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 PROSPECT AVE STE 2",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011834",
            "telephone_number": "201-880-8303",
            "fax_number": "201-880-4893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIENER",
        "first_name": "PAUL",
        "middle_name": "NEIL",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-28",
        "last_updated": "2020-01-30",
        "certification_date": "2020-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "018834-1",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "QA4003741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hackensack, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 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.