Active NPI
Tracy Decristofaro, DPT
- Physical Therapist
- Atco, NJ
National Provider Identifier
1962951954
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 40QA01334400
- Practice address
- 114 Hayes Mill Rd # D
Atco, NJ 08004-2457 - Phone
- (856) 753-2000
- NPI assigned
- Oct 1, 2016
- Last updated
- Oct 1, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 40QA01334400 | NJ | Primary |
Addresses
Primary practice location
114 Hayes Mill Rd # D
Atco, NJ 08004-2457
Mailing address
114 Hayes Mill Rd D
Atco, NJ 08004
Phone (856) 753-2000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40QA01334400 | NJ | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bayada Home Health Care, Inc. | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1475280000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1475280000000",
"number": "1962951954",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "114 HAYES MILL RD D",
"city": "ATCO",
"state": "NJ",
"postal_code": "08004",
"telephone_number": "856-753-2000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "114 HAYES MILL RD # D",
"city": "ATCO",
"state": "NJ",
"postal_code": "080042457",
"telephone_number": "856-753-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DECRISTOFARO",
"first_name": "TRACY",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-10-01",
"last_updated": "2016-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NJ",
"license": "40QA01334400",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atco, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.