NPIMap

Organization Active NPI

Balanced Body Rehabilitation LLC

Doing business as Prime Orthopedic Rehabilitation

  • Physical Therapist
  • Tenafly, NJ
National Provider Identifier
1740690627
Registry record updated Mar 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
BALANCED BODY REHABILITATION LLC
Doing business as
Prime Orthopedic Rehabilitation
Practice address
111 Dean Dr
Tenafly, NJ 07670-2764
Phone
(201) 503-7173
Fax
(201) 503-7177
NPI assigned
May 1, 2014
Last updated
Mar 8, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Michal H PorathNPI 1407085012
Title
Owner
Phone
(201) 503-7173

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary

Addresses

Primary practice location

111 Dean Dr
Tenafly, NJ 07670-2764

Mailing address

111 Dean Dr Ste 1N
Tenafly, NJ 07670-2762
Phone (201) 503-7173

Other practice location 1

160 LeGrand Ave
Northvale, NJ 07647-2403
Phone (201) 503-7173

Other practice location 2

19 Regent St
Bergenfield, NJ 07621-3908
Phone (201) 417-0575

Other names 1

  • Prime Orthopedic Rehabilitation Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141030000749 NJ Part B Supplier - Physical/Occupational Therapy Group in Private Practice 0749401016 Receives reassigned benefits from 42 practitioners
Practice locations: Tenafly, NJ

National Provider Directory

National Provider Directory

Locations

160 Legrand Ave
Northvale, NJ 07647
Phone (201) 503-7173

111 Dean Dr
Ste 1N
Tenafly, NJ 07670
Phone (201) 402-7802

Practitioners & affiliated clinicians

Practitioners 44

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 44

NPI Registry JSON

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

{
    "created_epoch": "1398902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709856000000",
    "number": "1740690627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 DEAN DR STE 1N",
            "city": "TENAFLY",
            "state": "NJ",
            "postal_code": "076702762",
            "telephone_number": "201-503-7173",
            "fax_number": "201-503-7177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 DEAN DR",
            "city": "TENAFLY",
            "state": "NJ",
            "postal_code": "076702764",
            "telephone_number": "201-503-7173",
            "fax_number": "201-503-7177"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "160 LeGrand Ave",
            "address_purpose": "LOCATION",
            "city": "Northvale",
            "state": "NJ",
            "postal_code": "076472403",
            "country_code": "US",
            "telephone_number": "201-503-7173",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "19 Regent St",
            "address_purpose": "LOCATION",
            "city": "Bergenfield",
            "state": "NJ",
            "postal_code": "076213908",
            "country_code": "US",
            "telephone_number": "201-417-0575",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BALANCED BODY REHABILITATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-01",
        "last_updated": "2024-03-08",
        "certification_date": "2024-03-08",
        "status": "A",
        "authorized_official_last_name": "PORATH",
        "authorized_official_first_name": "MICHAL",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-503-7173"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prime Orthopedic Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Prime Orthopedic Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tenafly, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.