Individual provider Active NPI

Robert F O'Connell, PT

  • Physical Therapist
  • Union, NJ
National Provider Identifier
1972667970
Registry record updated Oct 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA00486800 Issued in NJ
Practice address
2780 Morris Ave
Ste 1B
Union, NJ 07083-4852
Phone
(908) 687-1830
Fax
(908) 687-3680
NPI assigned
Dec 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 40QA00486800 NJ Primary

Addresses

Primary practice location

2780 Morris Ave
Ste 1B
Union, NJ 07083-4852

Mailing address

30 Madison Ave
Maplewood, NJ 07040-2333
Phone (908) 687-1830

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110329000268 NJ Practitioner - Physical Therapist in Private Practice 5799968749 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Rutgers New Jersey Medical School, 1990
Medicare assignment
May accept Medicare assignment
Group practices
Summit Physical TherapyGroup PAC ID 4880649342, 4 clinicians

Practice addresses (Care Compare)

60 Morris Tpke
Suite 2W
Summit, NJ 07901-5007
Phone (908) 598-9009

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Physical Therapy Physical Therapist CurrentSince Feb 1, 1998 Accepting new patients
David J Jacobs, MD PA Past Accepting new patients

Locations

60 Morris Tpke
Ste 2W
Summit, NJ 07901
Phone (908) 598-9009

2780 Morris Ave
Ste 1B
Union, NJ 07083
Phone (908) 687-1830

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287532800000",
    "number": "1972667970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 MADISON AVE",
            "city": "MAPLEWOOD",
            "state": "NJ",
            "postal_code": "070402333",
            "telephone_number": "908-687-1830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2780 MORRIS AVE",
            "address_2": "STE 1B",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070834852",
            "telephone_number": "908-687-1830",
            "fax_number": "908-687-3680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'CONNELL",
        "first_name": "ROBERT",
        "middle_name": "F",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-21",
        "last_updated": "2010-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA00486800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Union, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2010; 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.

Verify at the official NPI Registry.