Emerson Medrano Mateo, DR PHYSICAL THERAPY

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

40QA01048000 Issued in NJ

Practice address

453 Glenwood Ave
Teaneck, NJ 07666-6405

Phone

(212) 365-4505

NPI assigned

May 11, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Therapy Wellness LLCGroup PAC ID 3577970276, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Therapy Wellness LLC

  • Physical Therapy Clinic/Center
  • Teaneck, NJ
  • NPI 1730773961

  Physical Therapist

  Medicare reassignment Care Compare group NPD Authorized official
• Emerson Physical Therapy and Rehabilitation ,Inc

  • Physical Therapy Clinic/Center
  • Union City, NJ
  • NPI 1164650800

  Physical Therapist

  NPD (past) Authorized official
• Emerson Physical Therapy and Rehabilitation, PC

  • Clinic/Center
  • Teaneck, NJ
  • NPI 1255595559
  NPD (past) Authorized official
• Occupational & Community Health Services, Inc

  • Family Nurse Practitioner
  • Union City, NJ
  • NPI 1720286024

  Physical Therapy

  NPD (past)

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614297600000",
    "number": "1992755607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "453 GLENWOOD AVE",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076666405",
            "telephone_number": "212-365-4505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "453 GLENWOOD AVE",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076666405",
            "telephone_number": "212-365-4505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATEO",
        "first_name": "EMERSON",
        "middle_name": "MEDRANO",
        "name_prefix": "Dr.",
        "credential": "DR  PHYSICAL THERAPY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2021-02-26",
        "certification_date": "2021-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "NY",
            "license": "024900",
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NJ",
            "license": "40QA01048000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kirsten R Martinko, APN, FNP-C
• Susan Martins, LCSW
• Mary Huss Zetelski, LCSW, LLC
• Stacie Marzolf, DO, MPH
• John Alfred Masso, N.P.
• Elizabeth R Mathews, NP-C
• Carolyn Matzkin, LCSW
• Leora Jessica Mayer, LSW
• Noelle Mayers, MD
• Elio C. Mayorga, MS, RD, CDN

• Physical Therapy Clinic/Center in Teaneck, NJ
• Providers in Teaneck, NJ by specialty
• Physical Therapy Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2021; 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.