NPIMap

Organization Active NPI

Ignite Rehab Corp

Doing business as Ignite Rehab

  • Occupational Therapist
  • Wayne, NJ
National Provider Identifier
1902542574
Registry record updated May 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Legal business name
IGNITE REHAB CORP
Doing business as
Ignite Rehab
Practice address
30 Winonah Ave
Wayne, NJ 07470-5939
Phone
(201) 344-2499
NPI assigned
May 6, 2022
Last updated
May 6, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2022

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

Authorized official

Name
James Dahdouh, OTR/LNPI 1255933446
Title
Owner., Occupational Therapist
Phone
(201) 344-2499

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU
Occupational Therapist 225X00000X NU Primary
Speech-Language Pathologist 235Z00000X NU

Addresses

Primary practice location

30 Winonah Ave
Wayne, NJ 07470-5939

Mailing address

30 Winonah Ave
Wayne, NJ 07470-5939
Phone (201) 344-2499

Other names 1

  • Ignite Rehab Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220705000011 NJ Part B Supplier - Physical/Occupational Therapy Group in Private Practice 7911387295 Receives reassigned benefits from 41 practitioners
Practice locations: Clifton, NJ; Wayne, NJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 45

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 45

NPI Registry JSON

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

{
    "created_epoch": "1651795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651795200000",
    "number": "1902542574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 WINONAH AVE",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074705939",
            "telephone_number": "201-344-2499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 WINONAH AVE",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074705939",
            "telephone_number": "201-344-2499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IGNITE REHAB CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-06",
        "last_updated": "2022-05-06",
        "certification_date": "2022-05-06",
        "status": "A",
        "authorized_official_last_name": "DAHDOUH",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "OWNER., OCCUPATIONAL THERAPIST",
        "authorized_official_telephone_number": "201-344-2499",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ignite Rehab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wayne, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2022; 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.