Individual provider Active NPI

Anthony J Manzella, DPT

  • Physical Therapist
  • Franklin Lakes, NJ
National Provider Identifier
1902037203
Registry record updated Jun 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01319200 Issued in NJ
Practice address
794 Franklin Ave Ste 204
Franklin Lakes, NJ 07417-1399
Phone
(201) 891-6100
NPI assigned
Aug 4, 2009
Last updated
Jun 25, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2024

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 40QA01319200 NJ Primary

Addresses

Primary practice location

794 Franklin Ave Ste 204
Franklin Lakes, NJ 07417-1399

Mailing address

794 Franklin Ave Ste 204
Franklin Lakes, NJ 07417-1399
Phone (201) 891-6100

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121011000609 NJ Practitioner - Physical Therapist in Private Practice 5092964874 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

794 Franklin Ave
Suite 204
Franklin Lakes, NJ 07417-1399
Phone (201) 891-6100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA01319200NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ferraro Spine & Rehabilitation, PC Physical Therapist CurrentSince Sep 5, 2012 Accepting new patients
VG Physical Therapy PastSince Sep 12, 2021 Accepting new patients

Locations

230 Midland Ave
Saddle Brook, NJ 07663
Phone (973) 478-2122

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, 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": "1249344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1902037203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "794 FRANKLIN AVE STE 204",
            "city": "FRANKLIN LAKES",
            "state": "NJ",
            "postal_code": "074171399",
            "telephone_number": "201-891-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "794 FRANKLIN AVE STE 204",
            "city": "FRANKLIN LAKES",
            "state": "NJ",
            "postal_code": "074171399",
            "telephone_number": "201-891-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANZELLA",
        "first_name": "ANTHONY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-04",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01319200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Franklin Lakes, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2024; 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.