Anthony Fano, PT,DPT
Individual provider Active NPI Physical Therapist · Pine Brook, NJ
NPI 1902633282 · NPPES record last updated Sep 19, 2024
Key facts
- NPI
- 1902633282
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 40QA02290500 (NJ)
- Practice address
- 321 Changebridge Rd
Pine Brook, NJ 07058-9583 - Phone
- (973) 396-8585
- Fax
- (973) 396-8587
- NPI assigned
- Sep 19, 2024
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Mile High Physical Therapy Professional Corporation
Practice addresses (Care Compare)
321 Changebridge Rd
Suite 103
Pine Brook, NJ 07058-9584
Phone (973) 396-8585
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241007001650 | NJ | Practitioner - Physical Therapist in Private Practice | 4587195128 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mile High Physical Therapy Professional Corporation | Physical Therapist | Current |
Accepting new patients |
Locations
321 Changebridge Rd
Pine Brook, NJ 07058
Phone (973) 396-8585
321 Changebridge Rd
Ste 103
Pine Brook, NJ 07058
Phone (973) 396-8585
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 40QA02290500 | NJ | Yes |
Addresses
Primary practice location
321 Changebridge Rd
Pine Brook, NJ 07058-9583
Mailing address
321 Changebridge Rd
Pine Brook, NJ 07058-9583
Phone (973) 396-8585
Other providers in Pine Brook, NJ
- Karol Espejo
- Eunoia Mental Health and Wellness
- Michelle J Evans
- F.S. Transportation Inc.
- Renee Fagan
- Cynthia Theres Fields
- Ava M Frotton
- Olivia Ana Galari
- Helen Graf
- Casey Hasenbein
All providers in Pine Brook, NJ · Physical Therapist in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 19, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.