Maria Petrongolo, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA01957700 Issued in NJ

Practice address

151 Fries Mill Rd Ste 1
Blackwood, NJ 08012-2016

Phone

(856) 374-3707

Fax

(856) 374-3708

NPI assigned

Apr 28, 2021

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, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cross Keys Physical Therapy Sports Medicine Center Inc.Group PAC ID 5799697041, 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.

• Cross Keys Physical Therapy Sports Medical Center, Inc

  • Physical Therapist
  • Turnersville, NJ
  • NPI 1528128600

  NJ, Physical Therapist

  Medicare reassignment Care Compare group NPD
• Recover Physical Therapy

  • Clinic/Center
  • Blackwood, NJ
  • NPI 1194354407

  NJ, Physical Therapist

  Medicare reassignment NPD
• Recover Physical Therapy

  • Physical Therapy Clinic/Center
  • Yardley, PA
  • NPI 1407427370
  NPD
• Recover Physical Therapy and Wellness

  • Physical Therapist
  • Laurel Springs, NJ
  • NPI 1053200162
  NPD (past)

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

{
    "created_epoch": "1619568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625875200000",
    "number": "1700469707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 FRIES MILL RD STE 1",
            "city": "TURNERSVILLE",
            "state": "NJ",
            "postal_code": "080122016",
            "telephone_number": "856-374-3707",
            "fax_number": "856-374-3708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 FRIES MILL RD STE 1",
            "city": "BLACKWOOD",
            "state": "NJ",
            "postal_code": "080122016",
            "telephone_number": "856-374-3707",
            "fax_number": "856-374-3708"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "181 N Broadway",
            "address_purpose": "LOCATION",
            "city": "Pennsville",
            "state": "NJ",
            "postal_code": "080701550",
            "country_code": "US",
            "telephone_number": "856-678-8000",
            "fax_number": "856-678-4900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETRONGOLO",
        "first_name": "MARIA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-28",
        "last_updated": "2021-07-10",
        "certification_date": "2021-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01957700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Penaverde
• Perry J Cicchini DC PA
• Marcella Perry
• Personalized Independent Living Opporuntities & Training Services
• Personalized Independent Living Opporuntities & Training Services
• Christine Ferandos Petrozzino, MD
• Pharmatech Consulting Group, LLC
• Philadelphia Health & Education Corp
• Philadelphia Health & Education Corporation
• Delia Marie Pierson, P.T.A.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2021; 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.