Individual provider Active NPI

Danielle V. Bazelak, PT, DPT

  • Physical Therapist
  • Vineland, NJ
National Provider Identifier
1770066037
Registry record updated Apr 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01803800 Issued in NJ
Practice address
80 S Main Rd
Vineland, NJ 08360-7829
Phone
(856) 500-3800
Fax
(856) 213-6549
NPI assigned
Sep 12, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2020

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 40QA01803800 NJ Primary

Addresses

Primary practice location

80 S Main Rd
Vineland, NJ 08360-7829

Mailing address

224 Strawbridge Dr Ste 100
Moorestown, NJ 08057-4602
Phone (856) 677-4000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260615000364 FL Practitioner - Physical Therapist in Private Practice 0244582542 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Total Therapy Florida LLCGroup PAC ID 5395091722, 24 clinicians

Practice addresses (Care Compare)

1499 E Venice Ave
Venice, FL 34292-3207
Phone (941) 451-8657

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Strive Physical Therapy Specialists LLC Physical Therapist Past Accepting new patients

Organizations & group practices 2

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": "1536710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585785600000",
    "number": "1770066037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 STRAWBRIDGE DR STE 100",
            "city": "MOORESTOWN",
            "state": "NJ",
            "postal_code": "080574602",
            "telephone_number": "856-677-4000",
            "fax_number": "856-234-3014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 S MAIN RD",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083607829",
            "telephone_number": "856-500-3800",
            "fax_number": "856-213-6549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAZELAK",
        "first_name": "DANIELLE",
        "middle_name": "V.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-12",
        "last_updated": "2020-04-02",
        "certification_date": "2020-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01803800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vineland, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2020; 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.