Individual provider Active NPI

Michael Yarish, DPT

  • Physical Therapist
  • Fort Lee, NJ
National Provider Identifier
1821567553
Registry record updated Nov 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01833600 Issued in NJ
Practice address
1622 Parker Ave
Fort Lee, NJ 07024-6927
Phone
(201) 661-3398
NPI assigned
Nov 26, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 26, 2018

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 40QA01833600 NJ Primary

Addresses

Primary practice location

1622 Parker Ave
Fort Lee, NJ 07024-6927

Mailing address

41 Dacotah Ave
Oakland, NJ 07436-2112
Phone (201) 405-0305

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190227000041 NJ Practitioner - Physical Therapist in Private Practice 2365780699 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Elite Spine and Sports Care of Fort Lee PCGroup PAC ID 4688919228, 3 clinicians
Elite Spine and Sports Care of Paramus CorporationGroup PAC ID 5294271128, 2 clinicians

Practice addresses (Care Compare)

1622 Parker Ave
Suite 2B
Fort Lee, NJ 07024-6927
Phone (201) 592-0800

37 W Century Rd
Suite 111
Paramus, NJ 07652-1466
Phone (201) 563-7095

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Elite Spine and Sports Care of Fort Lee PC Physical Therapist CurrentSince Nov 7, 2018 Accepting new patients
Elite Spine and Sports Care of Paramus Corporation Physical Therapist CurrentSince Jul 15, 2024 Accepting new patients

Locations

37 W Century Rd
Ste 111
Paramus, NJ 07652
Phone (201) 262-2244

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": "1543190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543190400000",
    "number": "1821567553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 DACOTAH AVE",
            "city": "OAKLAND",
            "state": "NJ",
            "postal_code": "074362112",
            "telephone_number": "201-405-0305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1622 PARKER AVE",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070246927",
            "telephone_number": "201-661-3398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YARISH",
        "first_name": "MICHAEL",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-11-26",
        "last_updated": "2018-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01833600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lee, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 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.