NPIMap

Organization Active NPI

Optimum Orthopedics Physical Therapy & Rehab Center II LLC

  • Physical Therapist
  • Montclair, NJ
National Provider Identifier
1952346355
Registry record updated Sep 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
QA08051 Issued in NJ
Legal business name
OPTIMUM ORTHOPEDICS PHYSICAL THERAPY & REHAB CENTER II LLC
Practice address
1 Greenwood Ave
Suite 100
Montclair, NJ 07042-3649
Phone
(973) 746-2424
Fax
(973) 746-5030
NPI assigned
Jun 19, 2006
Last updated
Sep 22, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2015

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

Authorized official

Name
Mr. Michael Q. Cerullo, MSPT, CSCSNPI 1255359444
Title
Owner/Operator
Phone
(973) 746-2424

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X QA08051 NJ Primary
Physical Therapist 225100000X QA10818 NJ
Physical Therapist 225100000X QA08619 NJ
Hand Occupational Therapist 225XH1200X TR01594 NJ

Addresses

Primary practice location

1 Greenwood Ave
Suite 100
Montclair, NJ 07042-3649

Mailing address

One Greenwood Ave
Suite 100
Montclair, NJ 07042-3617
Phone (973) 746-2424

National Provider Directory

National Provider Directory

Locations

1 Greenwood Ave
#11
Montclair, NJ 07042
Phone (973) 746-2424

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442880000000",
    "number": "1952346355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ONE GREENWOOD AVE",
            "address_2": "SUITE 100",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070423617",
            "telephone_number": "973-746-2424",
            "fax_number": "973-746-5030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GREENWOOD AVE",
            "address_2": "SUITE 100",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070423649",
            "telephone_number": "973-746-2424",
            "fax_number": "973-746-5030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMUM ORTHOPEDICS PHYSICAL THERAPY & REHAB CENTER II LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-19",
        "last_updated": "2015-09-22",
        "status": "A",
        "authorized_official_last_name": "CERULLO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "Q.",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "973-746-2424",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSPT, CSCS"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "QA08051",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "QA10818",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "QA08619",
            "primary": false
        },
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "NJ",
            "license": "TR01594",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montclair, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.