Individual provider Active NPI

Pauline Claire P Suan, PT

  • Physical Therapist
  • Colonia, NJ
National Provider Identifier
1740858661
Registry record updated Apr 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA02001700 Issued in NJ
Practice address
15 Prospect LN Ste 1D
Colonia, NJ 07067-3048
Phone
(732) 827-0028
NPI assigned
Jun 16, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2022

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 40QA02001700 NJ Primary

Addresses

Primary practice location

15 Prospect LN Ste 1D
Colonia, NJ 07067-3048

Mailing address

1311 Mamaroneck Ave Ste 140
White Plains, NY 10605-5224
Phone (888) 830-4125

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210628002929 NJ Practitioner - Physical Therapist in Private Practice 1456752427 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ivyrehab Network IncGroup PAC ID 3476539776, 658 clinicians

Practice addresses (Care Compare)

1071 Inman Ave
Unit 4
Edison, NJ 08820-1132
Phone (732) 518-8868

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA02001700NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ivyrehab Network Inc Physical Therapist CurrentSince Feb 1, 2022 Accepting new patients
Ivyrehab Network, Inc. Physical Therapist CurrentSince Feb 1, 2022 Accepting new patients
Ivyrehab Network Inc. Physical Therapist Current Accepting new patients
At Home by Enhance Therapies LLC Physical Therapist CurrentSince Jun 1, 2025 Accepting new patients
Colonia Spine & Wellness Center PA CurrentSince May 15, 2021 Accepting new patients

Locations

15 Prospect Ln
Ste 1D
Colonia, NJ 07067
Phone (732) 661-1121

1071 Inman Ave
Unit 4
Edison, NJ 08820
Phone (732) 518-8868

411 Hackensack Ave
Ste 200
Hackensack, NJ 07601
Phone (732) 987-3833

454 Passaic St
Hackensack, NJ 07601
Phone (201) 488-7905

400 Route 70
Lakewood, NJ 08701
Phone (732) 802-7512

1311 Mamaroneck Ave
Ste 140
White Plains, NY 10605
Phone (914) 265-4838

Organizations & group practices 5

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": "1623801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650931200000",
    "number": "1740858661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 MAMARONECK AVE STE 140",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106055224",
            "telephone_number": "888-830-4125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 PROSPECT LN STE 1D",
            "city": "COLONIA",
            "state": "NJ",
            "postal_code": "070673048",
            "telephone_number": "732-827-0028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUAN",
        "first_name": "PAULINE CLAIRE",
        "middle_name": "P",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-16",
        "last_updated": "2022-04-26",
        "certification_date": "2022-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA02001700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colonia, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2022; 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.