Optimal Form & Function, LLC
NPI 1194402180ActiveOrganization· Physical Therapist· Teaneck, NJ
Physical Therapist in Teaneck, New Jersey, registered in NPPES in June 2023. The authorized official on file is Michael Formisano, PT, DPT, OCS, Founder/Physical Therapist. Enrolled in Medicare as part b supplier - physical/occupational therapy group in private practice.
Overview
| NPI | 1194402180 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jun 30, 2023 |
| Last updated in NPPES | Dec 16, 2023 |
| Certified by provider | Dec 16, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | — | — |
| Physical Therapist, Orthopedic | 2251X0800X | — | — |
| Occupational Therapist | 225X00000X | — | — |
| Occupational Therapist, Hand | 225XH1200X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Physical/Occupational Therapy Group in Private Practice (NJ) |
|---|
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