Susan Bolanos
Individual provider Active NPI Physical Therapist · Secaucus, NJ
NPI 1790477149 · NPPES record last updated May 24, 2023
Key facts
- NPI
- 1790477149
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- Practice address
- 150 Flanagan Way
Secaucus, NJ 07094-3445 - Phone
- (201) 319-0010
- NPI assigned
- May 24, 2023
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Professional Occupational and Physical Therapy, PLLC
Practice addresses (Care Compare)
590 Anderson Ave
Cliffside Park, NJ 07010-1721
Phone (201) 941-8667
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231218003294 | NJ | Practitioner - Physical Therapist in Private Practice | 2668821547 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Professional Occupational & Physical Therapy, PLLC | Physical Therapist | Current |
Accepting new patients |
| Professional Occupational & Physical Therapy, PLLC | Physical Therapist | Current | Accepting new patients |
| Professional Occupational & Physical Therapy, PLLC | Physical Therapist | Current |
Accepting new patients |
Locations
590 Anderson Ave
Cliffside Pk, NJ 07010
Phone (201) 941-8667
70 Ridge Rd
Lyndhurst, NJ 07071
Phone (201) 933-4775
1 Greenwood Ave
Montclair, NJ 07042
Phone (973) 746-2424
150 Flanagan Way
Secaucus, NJ 07094
Phone (201) 319-0010
524 Williamstown Rd
Ste B1
Sicklerville, NJ 08081
Phone (856) 516-0591
576 Broadhollow Rd
Melville, NY 11747
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | NJ | Yes |
Addresses
Primary practice location
150 Flanagan Way
Secaucus, NJ 07094-3445
Mailing address
576 Broadhollow Rd
Melville, NY 11747-5002
Other providers in Secaucus, NJ
- Frederick Bernier
- Beyond Radix LLC
- Parth V Bhatt
- Rosa Boccia
- Naimat Bokhari
- Stephanie Taylor Borgono
- Eleonora A Bowers
- Robert Wayne Boyajian
- Asra Bozkurt
- BRPT Oon LLC
All providers in Secaucus, NJ · Physical Therapist in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 24, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.