Justin De la Pena, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA01588300 Issued in NJ

Practice address

142 John St
3Rd Floor
Hackensack, NJ 07601-4130

Phone

(201) 342-1404

Fax

(201) 342-1867

NPI assigned

Mar 25, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Kessler Institute for Rehabilitation, Inc.

  • Rehabilitation Hospital
  • Marlton, NJ
  • NPI 1528512266
  NPD (past)

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

{
    "created_epoch": "1427241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436659200000",
    "number": "1952795148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 LEXINGTON AVE",
            "city": "DUMONT",
            "state": "NJ",
            "postal_code": "076281718",
            "telephone_number": "646-535-7362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 JOHN ST",
            "address_2": "3RD FLOOR",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076014130",
            "telephone_number": "201-342-1404",
            "fax_number": "201-342-1867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LA PENA",
        "first_name": "JUSTIN",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-03-25",
        "last_updated": "2015-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01588300",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "0387341",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles Stephen Davis, MD
• Beverly Davison, MD
• Linda Davt, APN
• Saraswati Dayal, MD
• Mayievin De la Cruz
• Alexandra De Leon
• Emily Jean De Mado, PA-C
• Shreemayee De, DO
• Bianca Debellis
• Julia Angelina Debellis, M.D.

• Physical Therapist in Hackensack, NJ
• Providers in Hackensack, 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 Jul 12, 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.