Individual provider Active NPI

Samatha Thach, PT, DPT

  • Physical Therapist
  • Delran, NJ
National Provider Identifier
1811705726
Registry record updated Dec 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA02253300 Issued in NJ
Practice address
3104 Bridgeboro Rd Ste B
Delran, NJ 08075-9716
Phone
(856) 460-6424
Fax
(856) 544-3286
NPI assigned
Dec 23, 2024
Last updated
Dec 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2024

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 40QA02253300 NJ Primary

Addresses

Primary practice location

3104 Bridgeboro Rd Ste B
Delran, NJ 08075-9716

Mailing address

14 Parke Place Blvd Ste D
Sewell, NJ 08080-2662
Phone (856) 256-8393

Other practice location 1

30 W Maple Ave
Merchantville, NJ 08109-5104
Phone (856) 661-0200

Other practice location 2

14 Parke Place Blvd Ste D
Sewell, NJ 08080-2662
Phone (562) 568-3938

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA02253300NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Therasport Physical Therapy, LLC Physical Therapist CurrentSince Jan 1, 2025 Accepting new patients
Ipta Clinical, LLC Physical Therapist CurrentSince Mar 1, 2025 Accepting new patients
3 Dimensional Physical Therapy - Pelvic Health LLC Physical Therapist PastSince Feb 23, 2025 Accepting new patients

Locations

3104 Bridgeboro Rd
Ste B
Delran, NJ 08075
Phone (856) 460-6424

175 Route 70
Ste 19
Medford, NJ 08055
Phone (609) 257-3750

30 W Maple Ave
Merchantville, NJ 08109
Phone (856) 661-0200

14 Parke Place Blvd
Ste D
Sewell, NJ 08080
Phone (856) 256-8393

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": "1734912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734912000000",
    "number": "1811705726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 PARKE PLACE BLVD STE D",
            "city": "SEWELL",
            "state": "NJ",
            "postal_code": "080802662",
            "telephone_number": "856-256-8393",
            "fax_number": "856-256-8390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3104 BRIDGEBORO RD STE B",
            "city": "DELRAN",
            "state": "NJ",
            "postal_code": "080759716",
            "telephone_number": "856-460-6424",
            "fax_number": "856-544-3286"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30 W Maple Ave",
            "address_purpose": "LOCATION",
            "city": "Merchantville",
            "state": "NJ",
            "postal_code": "081095104",
            "country_code": "US",
            "telephone_number": "856-661-0200",
            "fax_number": "856-661-0204",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14 Parke Place Blvd Ste D",
            "address_purpose": "LOCATION",
            "city": "Sewell",
            "state": "NJ",
            "postal_code": "080802662",
            "country_code": "US",
            "telephone_number": "562-568-3938",
            "fax_number": "856-256-8390",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THACH",
        "first_name": "SAMATHA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-23",
        "last_updated": "2024-12-23",
        "certification_date": "2024-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA02253300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Delran, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.