Individual provider Active NPI

Elizabeth Paige Samuel, MPT

  • Physical Therapist
  • Sicklerville, NJ
National Provider Identifier
1861460362
Registry record updated Oct 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA00993000 Issued in NJ
Practice address
542 Berlin Cross Keys Rd
Winslow Plaza, Suite 1
Sicklerville, NJ 08081-4367
Phone
(856) 740-0009
Fax
(856) 262-0469
NPI assigned
Mar 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2013

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 40QA00993000 NJ Primary

Addresses

Primary practice location

542 Berlin Cross Keys Rd
Winslow Plaza, Suite 1
Sicklerville, NJ 08081-4367

Mailing address

223 Woodcreek Rd
Wenonah, NJ 08090-2062
Phone (609) 206-7708

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141216000506 NJ Practitioner - Physical Therapist in Private Practice 6406008143 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rehabclinics SPT Inc CurrentSince Jun 1, 2022 Accepting new patients
Rehabclinics SPT Inc. Current Accepting new patients

Locations

2144 US Highway 130
Ste 12
Bordentown, NJ 08505
Phone (609) 324-9320

Organizations & group practices 3

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": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382400000000",
    "number": "1861460362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "223 WOODCREEK RD",
            "city": "WENONAH",
            "state": "NJ",
            "postal_code": "080902062",
            "telephone_number": "609-206-7708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "542 BERLIN CROSS KEYS RD",
            "address_2": "WINSLOW PLAZA, SUITE 1",
            "city": "SICKLERVILLE",
            "state": "NJ",
            "postal_code": "080814367",
            "telephone_number": "856-740-0009",
            "fax_number": "856-262-0469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUEL",
        "first_name": "ELIZABETH",
        "middle_name": "PAIGE",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-09",
        "last_updated": "2013-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA00993000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sicklerville, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2013; 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.