Alexander T Miscannon

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA01942800 Issued in NJ

Practice address

600 Main St
Ste 8
Riverton, NJ 08077-1400

Phone

(856) 360-5630

NPI assigned

Sep 3, 2019

Sex

Male

Sole proprietor

No

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.

• Torq Physical Therapy & Associates

  • Physical Therapist
  • Riverton, NJ
  • NPI 1235736299

  NJ, Physical Therapist

  Medicare reassignment Care Compare group NPD Authorized official
• Mishock Physical Therapy LP

  • Physical Therapist
  • Newtown Square, PA
  • NPI 1003232554
  NPD
• Mishock Physical Therapy LP

  • Physical Therapist
  • Gilbertsville, PA
  • NPI 1689011173
  NPD

Specialty

Physical Therapist in Private Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Torq Physical Therapy and Associates 2 clinicians

Practice addresses (Care Compare)

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 3, 2021.

{
    "created_epoch": "1567468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630627200000",
    "number": "1750939799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 MAIN ST STE 8",
            "city": "RIVERTON",
            "state": "NJ",
            "postal_code": "080771400",
            "telephone_number": "856-360-5630",
            "fax_number": "610-933-3376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 MAIN ST",
            "address_2": "STE 8",
            "city": "RIVERTON",
            "state": "NJ",
            "postal_code": "080771400",
            "telephone_number": "856-360-5630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISCANNON",
        "first_name": "ALEXANDER",
        "middle_name": "T",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-03",
        "last_updated": "2021-09-03",
        "certification_date": "2021-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01942800",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT028019",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mina Atef Girgis, RPH
• Camellia K Jakominich
• Gary Steven Lillie, D.M.D.
• Stephanie Joanne Lucignano, COTA
• Lindsey Marie Meyer, OTR L
• New Jersey CVS Pharmacy LLC
• Melany Perez Esteva, LCSW
• Gianna Porco
• Qmanj, Inc.
• Riverton Chiropractic Associates, LLC

• All providers in Riverton, NJ
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 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.