Mary Grace Fondevilla Sembrano, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA01021100 Issued in NJ

Practice address

527 River Ave
Lakewood, NJ 08701

Phone

(732) 905-0700

Fax

(732) 364-4566

NPI assigned

Jun 25, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Mary Grace Capuno Fondevilla Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Specialty

Physical Therapist in Private Practice

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

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 and National Provider Directory roles.

• Empowerme Rehabilitation, LLC

  • Multi-Specialty Clinic/Center
  • Dallas, TX
  • NPI 1255900296

  Physical Therapist

  NPD
• Empowerme Rehabilitation, LLC

  • Multi-Specialty Clinic/Center
  • Williamsburg, VA
  • NPI 1881366730

  Physical Therapist

  NPD
• First Choice Health Groupllc

  • Chiropractor
  • Brick, NJ
  • NPI 1629165782
  NPD (past)
• Millennium Rehab Solutions Inc.

  • Physical Therapist
  • Bergenfield, NJ
  • NPI 1093717571
  NPD (past)

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

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1851327258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 TULIP COURT",
            "city": "HOWELL",
            "state": "NJ",
            "postal_code": "07731",
            "telephone_number": "843-276-6709",
            "fax_number": "732-202-8773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "527 RIVER AVE",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "08701",
            "telephone_number": "732-905-0700",
            "fax_number": "732-364-4566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEMBRANO",
        "first_name": "MARY GRACE",
        "middle_name": "FONDEVILLA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-25",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NJ",
            "license": "40QA01021100",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01021100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY GRACE",
            "last_name": "FONDEVILLA",
            "middle_name": "CAPUNO",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Select Care ABA Ma LLC
• Select Care ABA NC LLC
• Select Care ABA VA LLC
• Leah Selengut, MS/SLP
• Joseph Semah, LCSW
• Paul Sender, MD
• Debbie Senderovic, PHARMD, RPH
• Faiga Senderovits
• Rebecca Senderovits, RN
• Senior Speech and Swallowing

• Physical Therapist in Lakewood, NJ
• Providers in Lakewood, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.