Active NPI
Will Stanaback, PT, DPT
- Orthopedic Physical Therapist
- Florham Park, NJ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- 40QA01792500
- Practice address
- 140 Park Ave
Florham Park, NJ 07932-1049 - Phone
- (908) 277-8967
- NPI assigned
- Jul 9, 2018
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | 40QA01792500 | NJ | Primary |
Addresses
Primary practice location
140 Park Ave
Florham Park, NJ 07932-1049
Mailing address
140 Park Ave
Florham Park, NJ 07932-1049
Phone (908) 277-8967
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1 Diamond Hill Rd
Berkeley Heights, NJ 07922-2104
Phone (908) 273-4300
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40QA01792500 | NJ | MD | Orthopedic Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Summit Medical Group PA | Multi-Specialty | Current | Accepting new patients |
| Summit Medical Group PA | Current | Accepting new patients | |
| Summit Medical Group, Inc | Multi-Specialty | Past | Accepting new patients |
Locations
1 Diamond Hill Rd
Berkeley Heights, NJ 07922
Phone (908) 277-8868
140 Park Ave
Florham Park, NJ 07932
Phone (973) 285-7613
150 Floral Ave
New Providence, NJ 07974
Phone (908) 588-3890
Interoperability endpoints
- william.stanaback.1@2983.direct.athenahealth.com
Organizations & group practices 3
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.
-
- Multi-Specialty Clinic/Center
- Berkeley Heights, NJ
- NPI 1942254347
-
- Durable Medical Equipment & Medical Supplies
- Hackensack, NJ
- NPI 1043930555
-
dba St. Elizabeth Physicians
- Family Medicine Physician
- Erlanger, KY
- NPI 1750343216
Multi-Specialty
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1531094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1531094400000",
"number": "1962998427",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "140 PARK AVE",
"city": "FLORHAM PARK",
"state": "NJ",
"postal_code": "079321049",
"telephone_number": "908-277-8967"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "140 PARK AVE",
"city": "FLORHAM PARK",
"state": "NJ",
"postal_code": "079321049",
"telephone_number": "908-277-8967"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STANABACK",
"first_name": "WILL",
"credential": "PT, DPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-07-09",
"last_updated": "2018-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Therapist, Orthopedic",
"state": "NJ",
"license": "40QA01792500",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Florham Park, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.