Individual provider Active NPI

Daniel Leo Wallenstein, DPT, LPT

  • Physical Therapist
  • Cliffside Park, NJ
National Provider Identifier
1720455850
Registry record updated Feb 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01915600 Issued in NJ
Practice address
590 Anderson Ave
Cliffside Park, NJ 07010-1721
Phone
(201) 941-8667
Fax
(201) 941-3353
NPI assigned
Aug 24, 2015
Last updated
Feb 19, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 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 40QA01915600 NJ Primary
Athletic Trainer 2255A2300X NU

Addresses

Primary practice location

590 Anderson Ave
Cliffside Park, NJ 07010-1721

Mailing address

40 Conger St Apt 203a
Bloomfield, NJ 07003-3314
Phone (917) 837-7602

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200318000331 NJ Practitioner - Physical Therapist in Private Practice 0446688816 Reassigns benefits to 2 organizations
I20221208001401 NY Practitioner - Physical Therapist in Private Practice 0446688816 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Professional Occupational and Physical Therapy, PLLCGroup PAC ID 3779873401, shared by 43 NPIs, 497 clinicians

Practice addresses (Care Compare)

524 Williamstown Rd
Sicklerville, NJ 08081-1800
Phone (856) 516-0593

79 Ronald Reagan Blvd
Warwick, NY 10990-4105
Phone (845) 998-6509

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA01915600NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist CurrentSince Feb 24, 2020 Accepting new patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist Current Accepting new patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist Current Accepting new patients
Rothman Orthopaedics of New Jersey, LLC CurrentSince Nov 1, 2020 Accepting new patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist CurrentSince Nov 28, 2022 Accepting new patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist CurrentSince Feb 24, 2020 Accepting new patients
Rothman Institute of New Jersey, P.a. CurrentSince Nov 1, 2020 Accepting new patients

Locations

590 Anderson Ave
Cliffside Pk, NJ 07010
Phone (201) 941-8667

999 Route 73 N
Ste 401
Marlton, NJ 08053
Phone (609) 617-3546

1 Greenwood Ave
Montclair, NJ 07042
Phone (973) 746-2424

524 Williamstown Rd
Sicklerville, NJ 08081
Phone (856) 262-9564

524 Williamstown Rd
Ste B1
Sicklerville, NJ 08081
Phone (856) 516-0591

390 Old Hook Rd
Ste 103
Westwood, NJ 07675

123 Grove Ave
Cedarhurst, NY 11516
Phone (516) 374-4248

576 Broadhollow Rd
Melville, NY 11747

79 Ronald Reagan Blvd
Warwick, NY 10990
Phone (845) 328-8967

2142 Utopia Pkwy
Whitestone, NY 11357
Phone (718) 767-0610

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": "1440374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582070400000",
    "number": "1720455850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 CONGER ST APT 203A",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070033314",
            "telephone_number": "917-837-7602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "590 ANDERSON AVE",
            "city": "CLIFFSIDE PARK",
            "state": "NJ",
            "postal_code": "070101721",
            "telephone_number": "201-941-8667",
            "fax_number": "201-941-3353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLENSTEIN",
        "first_name": "DANIEL",
        "middle_name": "LEO",
        "credential": "DPT, LPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-24",
        "last_updated": "2020-02-19",
        "certification_date": "2020-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01915600",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cliffside Park, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 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.