Individual provider Active NPI

Debra Ellen Kreel, PT

  • Physical Therapist
  • Westwood, NJ
National Provider Identifier
1760546121
Registry record updated May 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA00374600 Issued in NJ
Practice address
24 Booker Street
Westwood, NJ 07675-2619
Phone
(201) 822-0100
Fax
(201) 822-0107
NPI assigned
Dec 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2021

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 40QA00374600 NJ Primary
Physical Therapist 225100000X 010648-1 NY

Addresses

Primary practice location

24 Booker Street
Westwood, NJ 07675-2619

Mailing address

1377 Motor Pkwy Ste 307
Islandia, NY 11749-5258
Phone (631) 580-5200

Other practice location 1

28-12 Broadway
Fair Lawn, NJ 07410-3924
Phone (201) 475-8482

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100415000365 NJ Practitioner - Physical Therapist in Private Practice 3173513702 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1986
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)

28 -12 Broadway
Fair Lawn, NJ 07410-3924
Phone (201) 475-8482

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
010648-1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ivyrehab Network Inc. Physical Therapist Current Accepting new patients
Ivyrehab Network Inc Physical Therapist CurrentSince May 10, 2021 Accepting new patients
Ivyrehab Network, Inc. Physical Therapist CurrentSince May 10, 2021 Accepting new patients
Sports Physical Therapy of New York, P.C. Physical Therapist Past Accepting new patients
Rockland Physical Therapy PLLC Physical Therapist PastSince Feb 1, 2003 Accepting new patients

Locations

731 Lacey Rd
Ste 3
Forked River, NJ 08731
Phone (609) 242-6780

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

656 Shrewsbury Ave
Ste 103
Tinton Falls, NJ 07701
Phone (732) 842-4198

1377 Motor Pkwy
Ste 307
Ronkonkoma, NY 11749

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": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620259200000",
    "number": "1760546121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1377 MOTOR PKWY STE 307",
            "city": "ISLANDIA",
            "state": "NY",
            "postal_code": "117495258",
            "telephone_number": "631-580-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 BOOKER STREET",
            "city": "WESTWOOD",
            "state": "NJ",
            "postal_code": "076752619",
            "telephone_number": "201-822-0100",
            "fax_number": "201-822-0107"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "28-12 Broadway",
            "address_purpose": "LOCATION",
            "city": "Fair Lawn",
            "state": "NJ",
            "postal_code": "074103924",
            "country_code": "US",
            "telephone_number": "201-475-8482",
            "fax_number": "201-475-8739",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KREEL",
        "first_name": "DEBRA",
        "middle_name": "ELLEN",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-20",
        "last_updated": "2021-05-06",
        "certification_date": "2021-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA00374600",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "010648-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westwood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 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.