Individual provider Active NPI

Mary Joy Ucol

  • Physical Therapist
  • Clifton, NJ
National Provider Identifier
1841323375
Registry record updated Aug 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01203200 Issued in NJ
Practice address
1187 Main Ave Ste 1C
Clifton, NJ 07011
Phone
(973) 400-8440
NPI assigned
Mar 13, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 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 40QA01203200 NJ Primary

Addresses

Primary practice location

1187 Main Ave Ste 1C
Clifton, NJ 07011

Mailing address

6 Highland Dr
Livingston, NJ 07039-2809
Phone (973) 400-8440

Other practice location 1

209 S Livingston Ave Ste 4
Livingston, NJ 07039-4042
Phone (973) 400-8440

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160112001055 NJ Practitioner - Physical Therapist in Private Practice 9335441054 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1187 Main Ave
Suite 1C
Clifton, NJ 07011-2252
Phone (973) 400-8440

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA01203200NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Peak Performance PT, PA Physical Therapist CurrentSince Jun 7, 2017 Accepting new patients

Locations

1187 Main Ave
Ste 1C
Clifton, NJ 07011
Phone (732) 823-7219

209 S Livingston Ave
Ste 4
Livingston, NJ 07039
Phone (732) 823-7219

Organizations & group practices 1

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": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724112000000",
    "number": "1841323375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 HIGHLAND DR",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070392809",
            "telephone_number": "973-400-8440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1187 MAIN AVE STE 1C",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "07011",
            "telephone_number": "973-400-8440"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "209 S Livingston Ave Ste 4",
            "address_purpose": "LOCATION",
            "city": "Livingston",
            "state": "NJ",
            "postal_code": "070394042",
            "country_code": "US",
            "telephone_number": "973-400-8440",
            "fax_number": "973-400-4124",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "UCOL",
        "first_name": "MARY JOY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-13",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01203200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2024; 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.