Nicholas Dugan

Primary specialty

Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X

License

40QA02058800 Issued in NJ

Practice address

55 Eagle Rock Ave
East Hanover, NJ 07936-3143

Phone

(201) 561-4681

NPI assigned

Nov 30, 2021

Last updated

Nov 30, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Natty Bandasak Physio PerformanceGroup PAC ID 4284025131, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Natty Bandasak Physio Performance

  dba Myokinetix

  • Physical Therapist
  • East Hanover, NJ
  • NPI 1770072142
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1638230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638230400000",
    "number": "1851059661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "243 SHERMAN AVE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073071929",
            "telephone_number": "551-358-8433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 EAGLE ROCK AVE",
            "city": "EAST HANOVER",
            "state": "NJ",
            "postal_code": "079363143",
            "telephone_number": "201-561-4681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUGAN",
        "first_name": "NICHOLAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-30",
        "last_updated": "2021-11-30",
        "certification_date": "2021-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "NJ",
            "license": "40QA02058800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dka Medical LLC
• Michele Bauzil Dolisca, NP
• William Domke II
• Mary Theresa Downey-Freiman, RN MSN OCN
• Dr. Joseph L. Cavallo, OD
• Douglas Dzema Jr., PT, DPT
• East Hanover Chiropractic & Wellness LLC
• East Hanover Family Dental
• Joyce Ann Echo, PH.D.
• Ejs Dental LLC

• Sports Medicine (Physical Medicine & Rehabilitation) Physician in East Hanover, NJ
• Providers in East Hanover, NJ by specialty
• Sports Medicine (Physical Medicine & Rehabilitation) Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2021; 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.