Individual provider Active NPI

Susan Rele, PT, DPT, CERT MDT

  • Orthopedic Physical Therapist
  • Mountainside, NJ
National Provider Identifier
1881637668
Registry record updated Nov 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
40QA00647600 Issued in NJ
Practice address
1111 US Highway 22
Mountainside, NJ 07092-2808
Phone
(908) 389-9100
Fax
(908) 389-9101
NPI assigned
Jun 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 40QA00647600 NJ Primary

Addresses

Primary practice location

1111 US Highway 22
Mountainside, NJ 07092-2808

Mailing address

1631 Larkspur Dr
Mountainside, NJ 07092-1346
Phone (908) 317-9742

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060130000733 NJ Practitioner - Physical Therapist in Private Practice 4284658790 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ivyrehab Network IncGroup PAC ID 3476539776, 658 clinicians

Practice addresses (Care Compare)

1071 Inman Ave
Unit 4
Edison, NJ 08820-1132
Phone (732) 518-8868

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ivyrehab Network Inc. Orthopedic CurrentSince Mar 22, 2024 Accepting new patients
Ivyrehab Network, Inc. Orthopedic CurrentSince Mar 22, 2024 Accepting new patients

Locations

1071 Inman Ave
Unit 4
Edison, NJ 08820
Phone (732) 518-8868

454 Passaic St
Hackensack, NJ 07601
Phone (201) 488-7905

1111 US Highway 22
Mountainside, NJ 07092
Phone (908) 389-9100

Organizations & group practices 2

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": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416441600000",
    "number": "1881637668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1631 LARKSPUR DR",
            "city": "MOUNTAINSIDE",
            "state": "NJ",
            "postal_code": "070921346",
            "telephone_number": "908-317-9742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 US HIGHWAY 22",
            "city": "MOUNTAINSIDE",
            "state": "NJ",
            "postal_code": "070922808",
            "telephone_number": "908-389-9100",
            "fax_number": "908-389-9101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RELE",
        "first_name": "SUSAN",
        "name_prefix": "Dr.",
        "credential": "PT, DPT, CERT MDT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-13",
        "last_updated": "2014-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NJ",
            "license": "40QA00647600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountainside, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2014; 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.