Active NPI
Thaddeus Marc Wilmanski, MSPT
- Physical Therapist
- Bayonne, NJ
National Provider Identifier
1851569461
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT40QA01035400
- Practice address
- 29 E 29TH St
Bayonne, NJ 07002-4654 - Phone
- (201) 858-5285
- NPI assigned
- Feb 16, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT40QA01035400 | NJ | Primary |
Addresses
Primary practice location
29 E 29TH St
Bayonne, NJ 07002-4654
Mailing address
16 Sunflower CT
Edison, NJ 08820-4312
Phone (908) 757-3423
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT40QA01035400 | NJ | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1203120000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1203120000000",
"number": "1851569461",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16 SUNFLOWER CT",
"city": "EDISON",
"state": "NJ",
"postal_code": "088204312",
"telephone_number": "908-757-3423"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29 E 29TH ST",
"city": "BAYONNE",
"state": "NJ",
"postal_code": "070024654",
"telephone_number": "201-858-5285"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILMANSKI",
"first_name": "THADDEUS",
"middle_name": "MARC",
"credential": "MSPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-02-16",
"last_updated": "2008-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NJ",
"license": "PT40QA01035400",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bayonne, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.