Lisa Hadeler Sullivan, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA00616700 Issued in NJ

Practice address

1420 Hwy 36
Hazlet, NJ 07730-1736

Phone

(732) 335-0398

Fax

(732) 335-9376

NPI assigned

Jun 25, 2009

Sex

Female

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, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Inner Dynamics Physical Therapy LLCGroup PAC ID 4284937665, 8 clinicians

Care in Motion, Physical Therapy LLCGroup PAC ID 0042697427, 3 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.

• Care in Motion Physical Therapy, LLC

  • Physical Therapy Clinic/Center
  • Shrewsbury, NJ
  • NPI 1831833979

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Inner Dynamics Physical Therapy LLC

  • Physical Therapist
  • Ocean, NJ
  • NPI 1831575075
  Medicare reassignment Care Compare group NPD
• Bayshore Community Hospital

  • Rehabilitation Hospital Unit
  • Shrewsbury, NJ
  • NPI 1942418629
  NPD (past)

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

{
    "created_epoch": "1245888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1250985600000",
    "number": "1700014065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "94 GARDEN RD",
            "city": "SHREWSBURY",
            "state": "NJ",
            "postal_code": "077024474",
            "telephone_number": "732-212-0601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 HWY 36",
            "city": "HAZLET",
            "state": "NJ",
            "postal_code": "077301736",
            "telephone_number": "732-335-0398",
            "fax_number": "732-335-9376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "LISA",
        "middle_name": "HADELER",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-25",
        "last_updated": "2009-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA00616700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rita Stenavage, LAC
• Stepwell Institute Physical Therapy LLC
• Jennifer Stigler, APN-C
• Shaylyn Maree Stilwell, M.S. ED, CCC-SLP
• Daniel Struble, LCSW
• George Tadroes
• Nancy Ann Tages, RP
• John P Taras, M.D.
• Christopher F Tavares, D.C.
• Tenaya Taylor, EDD, MSW, MBA, LSW

• Physical Therapist in Hazlet, NJ
• Providers in Hazlet, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2009; 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.