Individual provider Active NPI

Eisha Locascio

  • Physical Therapist
  • Wyckoff, NJ
National Provider Identifier
1922216712
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA00627500 Issued in NJ
Practice address
385 Clinton Ave
Wyckoff, NJ 07481-1934
Phone
(201) 848-4599
Fax
(201) 848-6336
NPI assigned
May 18, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 40QA00627500 NJ Primary

Addresses

Primary practice location

385 Clinton Ave
Wyckoff, NJ 07481-1934

Mailing address

385 Clinton Ave
Wyckoff, NJ 07481-1934
Phone (201) 848-4599

Other names 1

  • Eisha Husain Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070803000116 NJ Practitioner - Physical Therapist in Private Practice 1658462742 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA00627500NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sportscare Institute, Inc. Physical Therapist Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1922216712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "385 CLINTON AVE",
            "city": "WYCKOFF",
            "state": "NJ",
            "postal_code": "074811934",
            "telephone_number": "201-848-4599",
            "fax_number": "201-848-6336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "385 CLINTON AVE",
            "city": "WYCKOFF",
            "state": "NJ",
            "postal_code": "074811934",
            "telephone_number": "201-848-4599",
            "fax_number": "201-848-6336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOCASCIO",
        "first_name": "EISHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA00627500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EISHA",
            "last_name": "HUSAIN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wyckoff, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.