Individual provider Active NPI

Carlie Strazzullo, PT, DPT

  • Physical Therapist
  • Medford, NJ
National Provider Identifier
1992281232
Registry record updated Feb 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
175 Route 70 Ste 19
Medford, NJ 08055-2355
Phone
(609) 714-3378
NPI assigned
Jul 18, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2020

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 Primary

Addresses

Primary practice location

175 Route 70 Ste 19
Medford, NJ 08055-2355

Mailing address

175 Route 70 Ste 19
Medford, NJ 08055-2355
Phone (609) 714-3378

Other identifiers 1

IdentifierTypeStateIssuer
M0109840OtherNJQUALCARE

Other names 1

  • Carlie Flake Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181015001601 NJ Practitioner - Physical Therapist in Private Practice 3173875424 Reassigns benefits to 1 organization

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
Ipta Clinical, LLCGroup PAC ID 0749456119, 126 clinicians

Practice addresses (Care Compare)

175 Route 70
Suite 19
Medford, NJ 08055-2355
Phone (609) 714-3378

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ipta Clinical, LLC Physical Therapist CurrentSince Sep 4, 2018 Accepting new patients
3 Dimensional Physical Therapy - Pelvic Health LLC Physical Therapist CurrentSince Feb 23, 2025 Accepting new patients

Locations

175 Route 70
Ste 19
Medford, NJ 08055
Phone (609) 257-3750

1572 Route 206
Ste 4
Tabernacle, NJ 08088
Phone (609) 257-3750

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": "1531872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580947200000",
    "number": "1992281232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 ROUTE 70 STE 19",
            "city": "MEDFORD",
            "state": "NJ",
            "postal_code": "080552355",
            "telephone_number": "609-714-3378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 ROUTE 70 STE 19",
            "city": "MEDFORD",
            "state": "NJ",
            "postal_code": "080552355",
            "telephone_number": "609-714-3378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STRAZZULLO",
        "first_name": "CARLIE",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-18",
        "last_updated": "2020-02-06",
        "certification_date": "2020-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QUALCARE",
            "identifier": "M0109840",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARLIE",
            "last_name": "FLAKE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Medford, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2020; 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.