Performance Physical Therapy & Sports Conditioning LLC
NPI 1376763722ActiveOrganization· Physical Therapist· Wayne, NJ
Physical Therapist in Wayne, New Jersey, registered in NPPES in April 2007. The authorized official on file is Brad Samples, DPT, ATC, Partner, Physical Therapist. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1376763722 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Apr 26, 2007 |
| Last updated in NPPES | Feb 2, 2024 |
| Certified by provider | Feb 2, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | 40QA01180900 | NJ |
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 - Clinic/Group Practice (NJ) |
|---|
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