Individual provider Active NPI

Victoria Michelle Fortuna, PT, DPT

  • Physical Therapist
  • Atco, NJ
National Provider Identifier
1891578357
Registry record updated Aug 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA02201100 Issued in NJ
Practice address
501 5TH St Ste 1
Atco, NJ 08004-1861
Phone
(856) 768-3811
NPI assigned
Aug 17, 2023
Last updated
Aug 17, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2023

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 40QA02201100 NJ Primary

Addresses

Primary practice location

501 5TH St Ste 1
Atco, NJ 08004-1861

Mailing address

308 School House Rd
Williamstown, NJ 08094-3798
Phone (609) 617-1127

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231009002633 NJ Practitioner - Physical Therapist in Private Practice 1254786403 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA02201100NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Osprey Rehabilitation, LLC. CurrentSince Sep 1, 2023 Accepting new patients
Osprey Rehabilitation, LLC. Physical Therapist Current Accepting new patients
Rehabclinics SPT Inc. CurrentSince Sep 1, 2023 Accepting new patients
Rehabclinics SPT, Inc. CurrentSince Sep 1, 2023 Accepting new patients
Rehabclinics SPT Inc PastSince Aug 27, 2023 Accepting new patients

Locations

501 5th St
Ste 1
Atco, NJ 08004
Phone (856) 768-3811

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

240 S White Horse Pike
Ste C6
Hammonton, NJ 08037
Phone (609) 561-5308

127 Bridgeton Pike
Unit D
Mullica Hill, NJ 08062
Phone (856) 478-0275

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1692230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692230400000",
    "number": "1891578357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 SCHOOL HOUSE RD",
            "city": "WILLIAMSTOWN",
            "state": "NJ",
            "postal_code": "080943798",
            "telephone_number": "609-617-1127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 5TH ST STE 1",
            "city": "ATCO",
            "state": "NJ",
            "postal_code": "080041861",
            "telephone_number": "856-768-3811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORTUNA",
        "first_name": "VICTORIA",
        "middle_name": "MICHELLE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-17",
        "last_updated": "2023-08-17",
        "certification_date": "2023-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA02201100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atco, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2023; 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.