Individual provider Active NPI

Sandra Stoddard, DPT

  • Physical Therapist
  • Randolph, NJ
National Provider Identifier
1790187227
Registry record updated Sep 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01570000 Issued in NJ
Practice address
540 Route 10 West
Randolph, NJ 07869
Phone
(973) 366-6615
Fax
(973) 366-9427
NPI assigned
Sep 16, 2014
Last updated
Sep 16, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2014

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 40QA01570000 NJ Primary

Addresses

Primary practice location

540 Route 10 West
Randolph, NJ 07869

Mailing address

12 Dellwood Drive
Florham Park, NJ 07932
Phone (973) 966-6620

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141013001627 NJ Practitioner - Physical Therapist in Private Practice 8527288679 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iron Physical TherapyGroup PAC ID 6002092228, 8 clinicians

Practice addresses (Care Compare)

474 Bloomfield Ave
Caldwell, NJ 07006-5402
Phone (973) 228-4766

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA01570000NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Iron Physical Therapy CurrentSince Feb 29, 2024 Accepting new patients
Carbon Health & Wellness, LLC CurrentSince Nov 13, 2023 Accepting new patients
Precision Upper Cervical PA PastSince Feb 2, 2011 Accepting new patients

Locations

474 Bloomfield Ave
Caldwell, NJ 07006
Phone (973) 228-3708

20 Franklin Tpke
Ste 218
Waldwick, NJ 07463
Phone (201) 749-6610

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1410825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410825600000",
    "number": "1790187227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 DELLWOOD DRIVE",
            "city": "FLORHAM PARK",
            "state": "NJ",
            "postal_code": "07932",
            "telephone_number": "973-966-6620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 ROUTE 10 WEST",
            "city": "RANDOLPH",
            "state": "NJ",
            "postal_code": "07869",
            "telephone_number": "973-366-6615",
            "fax_number": "973-366-9427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STODDARD",
        "first_name": "SANDRA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-16",
        "last_updated": "2014-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01570000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Randolph, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2014; 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.