Individual provider Active NPI

Nicolas Del Valle Sanchez

  • Physical Therapist
  • Newark, NJ
National Provider Identifier
1720652977
Registry record updated May 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01990800 Issued in NJ
Practice address
221 Chestnut St
Newark, NJ 07105-1558
Phone
(973) 491-6500
Fax
(973) 491-6303
NPI assigned
May 13, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2021

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 40QA01990800 NJ Primary

Addresses

Primary practice location

221 Chestnut St
Newark, NJ 07105-1558

Mailing address

576 Broadhollow Rd
Melville, NY 11747-5002
Phone (631) 359-5859

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210520002019 NJ Practitioner - Physical Therapist in Private Practice 7315346566 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jag-One Physical Therapy LLCGroup PAC ID 2769584325, 334 clinicians

Practice addresses (Care Compare)

2107 Route 35
Holmdel, NJ 07733-2795
Phone (732) 856-9791

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA01990800NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist Current Accepting new patients
Jag-One Physical Therapy, LLC Physical Therapist CurrentSince Sep 18, 2023 Accepting new patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist CurrentSince May 10, 2021 Accepting new patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist CurrentSince May 10, 2021 Accepting new patients

Locations

981 US Highway 22
Fl 2
Bridgewater, NJ 08807
Phone (908) 231-0511

2107 State Route 35
Holmdel, NJ 07733
Phone (732) 587-5065

70 Ridge Rd
Lyndhurst, NJ 07071
Phone (201) 933-4775

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

221 Chestnut St
Newark, NJ 07105
Phone (973) 491-6500

221 Rockingham Row
Princeton, NJ 08540
Phone (609) 580-1520

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

622 Eagle Rock Ave
West Orange, NJ 07052
Phone (973) 669-0078

576 Broadhollow Rd
Melville, NY 11747

Organizations & group practices 4

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": "1620864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620864000000",
    "number": "1720652977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "576 BROADHOLLOW RD",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117475002",
            "telephone_number": "631-359-5859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 CHESTNUT ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071051558",
            "telephone_number": "973-491-6500",
            "fax_number": "973-491-6303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEL VALLE SANCHEZ",
        "first_name": "NICOLAS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-13",
        "last_updated": "2021-05-13",
        "certification_date": "2021-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01990800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 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.