NPIMap

Organization Active NPI

Ivyrehab Network, Inc.

  • Physical Medicine & Rehabilitation Physician
  • Medford, NJ
National Provider Identifier
1831717404
Registry record updated Apr 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
IVYREHAB NETWORK, INC.
Practice address
176 Route 70 Ste 14
Medford, NJ 08055-8704
Phone
(856) 533-0920
NPI assigned
Jul 10, 2020
Last updated
Apr 11, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2023

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

Authorized official

Name
Ashley Griffiths
Title
Director of Payer Relations
Phone
(914) 294-4050

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X Primary

Addresses

Primary practice location

176 Route 70 Ste 14
Medford, NJ 08055-8704

Mailing address

1311 Mamaroneck Ave Ste 140
White Plains, NY 10605-5224
Phone (914) 294-4050

Other practice location 1

131 Route 70 Ste 110
Medford, NJ 08055-9501
Phone (856) 533-0920

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211008001738 NJ DME Supplier - Independently-Practicing Occupational TherapistDME Supplier - Independently-Practicing Physical Therapist 3476539776 Practice locations: Medford, NJ

Other NPIs with the same Medicare PAC ID 10

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Ivyrehab Network Inc15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

Locations

131 Route 70
#110
Medford, NJ 08055
Phone (856) 375-1110

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1594339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681171200000",
    "number": "1831717404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 MAMARONECK AVE STE 140",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106055224",
            "telephone_number": "914-294-4050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "176 ROUTE 70 STE 14",
            "city": "MEDFORD",
            "state": "NJ",
            "postal_code": "080558704",
            "telephone_number": "856-533-0920"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "131 Route 70 Ste 110",
            "address_purpose": "LOCATION",
            "city": "Medford",
            "state": "NJ",
            "postal_code": "080559501",
            "country_code": "US",
            "telephone_number": "856-533-0920",
            "fax_number": "856-375-1110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "IVYREHAB NETWORK, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-10",
        "last_updated": "2023-04-11",
        "certification_date": "2023-04-11",
        "status": "A",
        "authorized_official_last_name": "GRIFFITHS",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "DIRECTOR OF PAYER RELATIONS",
        "authorized_official_telephone_number": "914-294-4050"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2023; 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.