NPIMap

Organization Active NPI

Physical Medicine and Rehabilitation Center PA

  • Rehabilitation Practitioner
  • Englewood, NJ
National Provider Identifier
1831110469
Registry record updated Jun 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PractitionerTaxonomy code 225400000X
Legal business name
PHYSICAL MEDICINE AND REHABILITATION CENTER PA
Practice address
500 Grand Ave
Ste 100
Englewood, NJ 07631-4968
Phone
(201) 567-2277
NPI assigned
Jul 21, 2006
Last updated
Jun 9, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2014

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

Authorized official

Name
Mrs. Tracy Isaacs-Pindus
Title
Billing Manager
Phone
(201) 567-2277

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Practitioner 225400000X NU Primary

Addresses

Primary practice location

500 Grand Ave
Ste 100
Englewood, NJ 07631-4968

Mailing address

500 Grand Ave
Ste 100
Englewood, NJ 07631-4968
Phone (201) 567-2277

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20040121000094 NJ Part B Supplier - Clinic/Group Practice 1658273750 Receives reassigned benefits from 35 practitioners
Practice locations: Englewood, NJ
O20040512001265 NY Part B Supplier - Clinic/Group Practice 1658273750 Receives reassigned benefits from 33 practitioners
Practice locations: Bardonia, NY
O20100930061644 NJ DME Supplier - Physician - Physical and RehabilitationDME Supplier - Independently-Practicing Physical TherapistDME Supplier - Independently-Practicing Occupational Therapist 1658273750 Practice locations: Englewood, NJ

National Provider Directory

National Provider Directory

Locations

15 Engle St
Ste 205
Englewood, NJ 07631
Phone (201) 567-2277

500 Grand Ave
#1
Englewood, NJ 07631
Phone 2015672277 ext. 229

500 Grand Ave
Ste 100
Englewood, NJ 07631
Phone (201) 227-1760

365 Route 304
Ste 102
Nanuet, NY 10954
Phone (845) 624-2182

Practitioners & affiliated clinicians

Practitioners 102

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 102

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402272000000",
    "number": "1831110469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 GRAND AVE",
            "address_2": "STE 100",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076314968",
            "telephone_number": "201-567-2277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 GRAND AVE",
            "address_2": "STE 100",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076314968",
            "telephone_number": "201-567-2277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL MEDICINE AND REHABILITATION CENTER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-21",
        "last_updated": "2014-06-09",
        "status": "A",
        "authorized_official_last_name": "ISAACS-PINDUS",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "201-567-2277",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "NU",
            "license": null,
            "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 Jun 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.