Spectrum Physical Therapy & Athletic Training, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA01107700 Issued in NJ

Legal business name

SPECTRUM PHYSICAL THERAPY & ATHLETIC TRAINING, LLC

Practice address

1203 River Rd
Suite 4
Edgewater, NJ 07020-1456

Phone

(201) 937-3600

Fax

(201) 731-5192

NPI assigned

Oct 25, 2006

Last updated

May 15, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Gregory R. Zaccone, DPT, SCS,NPI 1861577421

Title

President

Phone

(201) 937-3600

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 15

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.

• Gregory R. Zaccone, PT, DPT, MSPT, SCS

  • Physical Therapist
  • Old Tappan, NJ
  • NPI 1861577421
  Medicare reassignment NPD Authorized official
• Michael Anthony Arocho Jr., DPT

  • Physical Therapist
  • Old Tappan, NJ
  • NPI 1497423842
  Medicare reassignment NPD
• Thomas Matthew Donofrio, PT

  • Sports Physical Therapist
  • Northvale, NJ
  • NPI 1093731036
  Medicare reassignment NPD
• Asante Hohn, PT, DPT

  • Physical Therapist
  • Edgewater, NJ
  • NPI 1013550284

  Single Specialty

  Medicare reassignment NPD
• Tracey M Grant, DPT

  • Physical Therapist
  • Uniondale, NY
  • NPI 1215192802

  NJ

  Medicare reassignment NPD
• Shevaun K Kirschbaum, P.T., D.P.T.

  • Physical Therapist
  • Piermont, NY
  • NPI 1720359136

  NJ

  Medicare reassignment NPD
• Anthony J Perrone, DPT, PT

  • Physical Therapist
  • Matawan, NJ
  • NPI 1699053389
  Medicare reassignment
• Artur Mullokandov, DPT

  • Physical Therapist
  • Union City, NJ
  • NPI 1295002988
  NPD
• Joshua Perez, DPT

  • Physical Therapist
  • Old Tappan, NJ
  • NPI 1386327443
  NPD
• Christopher Vecchione

  • Physical Therapist
  • Emerson, NJ
  • NPI 1891864476
  NPD
• Jessica Lynn De Palma, P.T.

  • Physical Therapist
  • Fair Lawn, NJ
  • NPI 1841508256
  NPD (past)
• Leonard Jesus Somarriba

  • Orthopedic Physical Therapist
  • Aberdeen, NJ
  • NPI 1629224647
  NPD (past)

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368576000000",
    "number": "1942385513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "184 CENTRAL AVE",
            "address_2": "1ST FLOOR",
            "city": "OLD TAPPAN",
            "state": "NJ",
            "postal_code": "076757360",
            "telephone_number": "201-768-2099",
            "fax_number": "201-731-5192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1203 RIVER RD",
            "address_2": "SUITE 4",
            "city": "EDGEWATER",
            "state": "NJ",
            "postal_code": "070201456",
            "telephone_number": "201-937-3600",
            "fax_number": "201-731-5192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECTRUM PHYSICAL THERAPY & ATHLETIC TRAINING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2013-05-15",
        "status": "A",
        "authorized_official_last_name": "ZACCONE",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-937-3600",
        "authorized_official_credential": "DPT, SCS,"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01107700",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "0256111",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "097268",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Smiles on the Hudson PC
• Anna Caroline Smith
• Audrey P Soboczynski, FNP-C
• Kevin M Soriano, MD
• Diane Alexy Sosa, LPC
• Spectrum Physical Therapy and Athletic Training LLC
• Margaret B. Steele, L.AC., C.A.
• Daniel Y Suh, D.M.D
• Summit Medical Group PA (CityMD)
• Summit Medical Group PA (Citymd)

• Physical Therapist in Edgewater, NJ
• Providers in Edgewater, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2013; 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.