Natty Bandasak Physio Performance

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

NATTY BANDASAK PHYSIO PERFORMANCE

Practice address

55 Eagle Rock Ave
East Hanover, NJ 07936-3143

Phone

(973) 397-5868

NPI assigned

May 1, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Natty Bandasak, DPTNPI 1164964094

Title

Owner

Phone

(973) 370-0198

Specialties & licenses 1

Addresses

Other names 1

• Myokinetix Doing business as

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Natty Bandasak

  • Physical Therapist
  • East Hanover, NJ
  • NPI 1164964094
  Medicare reassignment Care Compare group NPD Authorized official
• Nicholas Dugan

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • East Hanover, NJ
  • NPI 1851059661
  Medicare reassignment Care Compare group NPD
• Kevin Pineda, DPT

  • Physical Medicine & Rehabilitation Physician
  • Fair Lawn, NJ
  • NPI 1386300697
  Medicare reassignment Care Compare group NPD
• Jennifer Marie Boyle, PT, DPT

  • Physical Therapist
  • East Hanover, NJ
  • NPI 1356868178
  Medicare reassignment NPD
• Matthew W Fung, PT, DPT, OCS, CSCS

  • Physical Therapist
  • Succasunna, NJ
  • NPI 1689155798
  Medicare reassignment NPD

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

{
    "created_epoch": "1525132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734998400000",
    "number": "1770072142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 W JERSEY ST APT 5F",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072021319",
            "telephone_number": "973-379-0198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 EAGLE ROCK AVE",
            "city": "EAST HANOVER",
            "state": "NJ",
            "postal_code": "079363143",
            "telephone_number": "973-397-5868"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22 Hollywood Ave",
            "address_purpose": "LOCATION",
            "city": "Ho Ho Kus",
            "state": "NJ",
            "postal_code": "074231437",
            "country_code": "US",
            "telephone_number": "973-397-5868",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NATTY BANDASAK PHYSIO PERFORMANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-01",
        "last_updated": "2024-12-24",
        "certification_date": "2024-12-24",
        "status": "A",
        "authorized_official_last_name": "BANDASAK",
        "authorized_official_first_name": "NATTY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-370-0198",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Myokinetix",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kara Louise Motsch, RD
• Amy Mourad, PT, MS
• Daniel Muniz
• Todd Muoio, DPT
• Giuseppe Musso, D.C.
• Nazarri Sportscare
• Joseph Thomas Nazzari
• Neuro Pro Wellness LLC
• Neuropsychological and Psychodiagnostic Assessment Center of NJ
• New Jersey CVS Pharmacy LLC

• Physical Therapist in East Hanover, NJ
• Providers in East Hanover, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 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.