Individual provider Active NPI

Norman A Roque, PT, OCS, CHT

  • Hand Physical Therapist
  • Englewood, NJ
National Provider Identifier
1811051865
Registry record updated May 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hand Physical TherapistTaxonomy code 2251H1200X
License
40QA00800700 Issued in NJ
Practice address
401 S Van Brunt St
Englewood, NJ 07631
Phone
(201) 569-2770
NPI assigned
Dec 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2018

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 019359 NY
Physical Therapist 225100000X 40QA00800700 NJ
Orthopedic Physical Therapist 2251X0800X 40QA00800700 NJ
Hand Physical Therapist 2251H1200X 40QA00800700 NJ Primary

Addresses

Primary practice location

401 S Van Brunt St
Englewood, NJ 07631

Mailing address

401 S Van Brunt St Ste 3
Englewood, NJ 07631-4600
Phone (201) 569-2770

Other practice location 1

266-272 Chestnut St
Newark, NJ 07105-6521
Phone (973) 732-3850

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160408000092 NJ Practitioner - Physical Therapist in Private Practice 1759482797 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Associates of Englewood PCGroup PAC ID 1355512252, 538 clinicians

Practice addresses (Care Compare)

24 Elm St
Harrington Park, NJ 07640-1902
Phone (201) 451-1601

910 Sylvan Ave
Suite 110
Englewood, NJ 07632-3306
Phone (551) 501-8989

Merit-based Incentive Payment System (MIPS)

Final score
96.09 of 100Reported as apm
Quality
86.89
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019359NYMDPhysical Medicine & Rehabilitation Physician
40QA00800700NJMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Liberty Physical Therapy PC Physical Therapist CurrentSince Apr 11, 2016 Accepting new patients
Medical Associates of Englewood, PC CurrentSince Sep 1, 2019 Accepting new patients

Locations

401 S Van Brunt St
Ste 206
Englewood, NJ 07631
Phone (201) 937-8215

401 S Van Brunt St
Ste 3
Englewood, NJ 07631

910 Sylvan Ave
Fl 1
Englewood Cliffs, NJ 07632

910 Sylvan Ave
Ste 100
Englewood Cliffs, NJ 07632

24 Elm St
Ste 203
Harrington Pk, NJ 07640
Phone (201) 784-0123

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": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526515200000",
    "number": "1811051865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 S VAN BRUNT ST STE 3",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076314600",
            "telephone_number": "201-569-2770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 S VAN BRUNT ST",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "07631",
            "telephone_number": "201-569-2770"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "266-272 Chestnut St",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "NJ",
            "postal_code": "071056521",
            "country_code": "US",
            "telephone_number": "973-732-3850",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROQUE",
        "first_name": "NORMAN",
        "middle_name": "A",
        "credential": "PT, OCS, CHT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-21",
        "last_updated": "2018-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "019359",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA00800700",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NJ",
            "license": "40QA00800700",
            "primary": false
        },
        {
            "code": "2251H1200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Hand",
            "state": "NJ",
            "license": "40QA00800700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2018; 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.