Active NPI
Eric Ivancich, DPT
- Physical Therapist
- Whiting, NJ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 40QA01423900
- Practice address
- 67 Lacey Rd
Whiting, NJ 08759-2912 - Phone
- (732) 849-0700
- NPI assigned
- Nov 15, 2011
- Sex
- Male
- Sole proprietor
- No
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 | 40QA01423900 | NJ | Primary |
Addresses
Primary practice location
67 Lacey Rd
Whiting, NJ 08759-2912
Mailing address
67 Lacey Rd
Whiting, NJ 08759-2912
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, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
300 Princeton Hightstown Rd
Suite 201
East Windsor, NJ 08520-1411
Phone (609) 426-4442
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40QA01423900 | NJ | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ivyrehab Network Inc. | Physical Therapist | Current | Accepting new patients |
| Ivyrehab Network Inc | Physical Therapist | Current | Accepting new patients |
| Ivyrehab Network, Inc. | Physical Therapist | Current | Accepting new patients |
Locations
849 W Bay Ave
Ste 4
Barnegat, NJ 08005
Phone (609) 660-1900
731 Lacey Rd
Ste 3
Forked River, NJ 08731
Phone (609) 242-6780
600 Mule Rd
Toms River, NJ 08757
Phone (732) 505-1300
1377 Motor Pkwy
Ste 307
Ronkonkoma, NY 11749
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.
-
- Physical Therapist
- Hoboken, NJ
- NPI 1174577274
-
- Physical Therapist
- Hoboken, NJ
- NPI 1861623753
-
- Physical Medicine & Rehabilitation Physician
- Cranford, NJ
- NPI 1699590265
Physical Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1321315200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323388800000",
"number": "1972880201",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "67 LACEY RD",
"city": "WHITING",
"state": "NJ",
"postal_code": "087592912"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "67 LACEY RD",
"city": "WHITING",
"state": "NJ",
"postal_code": "087592912",
"telephone_number": "732-849-0700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IVANCICH",
"first_name": "ERIC",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-11-15",
"last_updated": "2011-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NJ",
"license": "40QA01423900",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Whiting, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2011; 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.