Atlas Physical Therapy

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA00442100NJ Issued in NJ

Legal business name

ATLAS PHYSICAL THERAPY

Practice address

405 Northfield Avenue
Suite 200
West Orange, NJ 07052-3023

Phone

(973) 325-7212

Fax

(973) 325-7214

NPI assigned

Nov 24, 2006

Organization subpart

No

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

Authorized official

Name

Tsambikos A Dimitrakis, PT, MTCNPI 1487687646

Title

President/Owner

Phone

(973) 325-7212

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tsambikos Anastasiou Dimitrakis, PT

  • Physical Therapist
  • West Orange, NJ
  • NPI 1487687646
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1164326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304640000000",
    "number": "1881760627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 NORTHFIELD AVENUE",
            "address_2": "SUITE 200",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070523023",
            "telephone_number": "973-325-7212",
            "fax_number": "973-325-7214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 NORTHFIELD AVENUE",
            "address_2": "SUITE 200",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070523023",
            "telephone_number": "973-325-7212",
            "fax_number": "973-325-7214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLAS PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-24",
        "last_updated": "2011-05-06",
        "status": "A",
        "authorized_official_last_name": "DIMITRAKIS",
        "authorized_official_first_name": "TSAMBIKOS",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "973-325-7212",
        "authorized_official_credential": "PT, MTC"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA00442100NJ",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA00442100",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in West Orange, NJ
• Providers in West Orange, 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 May 6, 2011; 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.