Form Physical Therapy LLC
NPI 1053254540 · Physical Therapy Clinic/Center · West Orange, NJ
Form Physical Therapy LLC is a Physical Therapy Clinic/Center organization in West Orange, NJ (NPI 1053254540).
Provider details
- NPI number
- 1053254540
- Entity type
- Organization
- Primary specialty
- Physical Therapy Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Michael Feller, Owner/Physical Therapist(732) 221-6703
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
Under 1 yr in registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2026-04-10
- Last updated
- 2026-04-10
- Certified
- 2026-04-10
Frequently asked questions
- What is Form Physical Therapy LLC's NPI number?
- Form Physical Therapy LLC's National Provider Identifier (NPI) is 1053254540, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Form Physical Therapy LLC?
- Form Physical Therapy LLC is classified in the NPPES registry as Physical Therapy Clinic/Center (Ambulatory Health Care Facilities).
- Where is Form Physical Therapy LLC located?
- Form Physical Therapy LLC's practice location on file with NPPES is 39 Colonial Woods Dr, West Orange, NJ 07052-1614.
- What is Form Physical Therapy LLC's phone number?
- The practice phone number listed in the NPPES registry for Form Physical Therapy LLC is (732) 221-6703.
- Who is the authorized official for Form Physical Therapy LLC?
- The authorized official listed on Form Physical Therapy LLC's NPPES record is Michael Feller, Owner/Physical Therapist. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Form Physical Therapy LLC's NPI active?
- Yes — Form Physical Therapy LLC's NPI (1053254540) is active in the NPPES registry as of the last update on 2026-04-10.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.