Individual provider Active NPI

Carly Gossard, PT, DPT, OCS, PRPC

  • Physical Therapist
  • Montvale, NJ
National Provider Identifier
1710370408
Registry record updated Feb 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
160 Summit Ave Ste 204
Montvale, NJ 07645-1763
Phone
(201) 305-0130
Fax
(833) 538-0115
NPI assigned
Mar 5, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2025

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 Primary

Addresses

Primary practice location

160 Summit Ave Ste 204
Montvale, NJ 07645-1763

Mailing address

160 Summit Ave Ste 204
Montvale, NJ 07645-1763
Phone (201) 305-0130

Other practice location 1

119 E Passaic St
Maywood, NJ 07607-1342
Phone (201) 880-7787

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160523001457 NJ Practitioner - Physical Therapist in Private Practice 4688963127 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Empowered Pelvic Health LLCGroup PAC ID 2961829726, 3 clinicians

Practice addresses (Care Compare)

160 Summit Ave
Suite 204
Montvale, NJ 07645-1763
Phone (201) 305-0130

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Empowered Pelvic Therapy LLC Physical Therapist CurrentSince Mar 1, 2025 Accepting new patients
Protouch Physical Therapy Group LLC Physical Therapist CurrentSince Oct 1, 2019 Accepting new patients
Empowered Pelvic Health LLC Physical Therapist CurrentSince Aug 25, 2020 Accepting new patients
Emerson Physical Therapy LLC CurrentSince Mar 12, 2019 Accepting new patients
Maywood Physical Therapy LLC CurrentSince May 31, 2016 Accepting new patients

Locations

570 South Ave E
Bldg G
Cranford, NJ 07016
Phone (908) 272-7990

45 Emerson Plz E
Ste 102
Emerson, NJ 07630
Phone (201) 477-8415

119 E Passaic St
Maywood, NJ 07607
Phone (201) 880-7787

160 Summit Ave
Ste 204
Montvale, NJ 07645
Phone (201) 305-0130

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1425513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740355200000",
    "number": "1710370408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 SUMMIT AVE STE 204",
            "city": "MONTVALE",
            "state": "NJ",
            "postal_code": "076451763",
            "telephone_number": "201-305-0130",
            "fax_number": "833-538-0115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 SUMMIT AVE STE 204",
            "city": "MONTVALE",
            "state": "NJ",
            "postal_code": "076451763",
            "telephone_number": "201-305-0130",
            "fax_number": "833-538-0115"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "119 E Passaic St",
            "address_purpose": "LOCATION",
            "city": "Maywood",
            "state": "NJ",
            "postal_code": "076071342",
            "country_code": "US",
            "telephone_number": "201-880-7787",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOSSARD",
        "first_name": "CARLY",
        "credential": "PT, DPT, OCS, PRPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-05",
        "last_updated": "2025-02-24",
        "certification_date": "2025-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montvale, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2025; 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.