PROADVANTAGE PHYSICAL THERAPY INCORPORATED
NPI 1003064452
Clinic/Center - Physical Therapy in Cliffside Park, NJ
About Proadvantage Physical Therapy Incorporated NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PROADVANTAGE PHYSICAL THERAPY INCORPORATED (NPI 1003064452) is a healthcare organization registered as a physical therapy in Cliffside Park, New Jersey and active in the NPI registry since August 2008. The organization lists Yevgeny Fedosenko, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Proadvantage Physical Therapy Incorporated is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Proadvantage Physical Therapy Incorporated, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Proadvantage Physical Therapy Incorporated's NPI number?
The NPI number for Proadvantage Physical Therapy Incorporated is 1003064452. It was assigned to this organization in the NPPES registry on August 28, 2008.
Where is Proadvantage Physical Therapy Incorporated located?
Proadvantage Physical Therapy Incorporated is located at 200 Winston Dr Apt 119, Cliffside Park, NJ 07010. The listed phone number is (617) 620-2137.
What is Proadvantage Physical Therapy Incorporated's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Physical Therapy, with taxonomy code 261QP2000X.
Is Proadvantage Physical Therapy Incorporated enrolled in Medicare?
Yes. Proadvantage Physical Therapy Incorporated is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Proadvantage Physical Therapy Incorporated?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Physical Therapist in Private Practice) reassigns their Medicare billing to Proadvantage Physical Therapy Incorporated. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Proadvantage Physical Therapy Incorporated was last updated on March 18, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Proadvantage Physical Therapy Incorporated · NPI 1003064452
Physical Therapy organization in Cliffside Park, New Jersey. Organization record, active in the CMS NPPES registry since August 28, 2008.
## Identity
- **NPI:** 1003064452 (Entity type: Organization)
- **Enumerated:** August 28, 2008
- **Primary specialty:** Clinic/Center - Physical Therapy · taxonomy 261QP2000X
- **Organization subpart:** No
- **Authorized official:** Yevgeny Fedosenko, OWNER
## Practice location
- **Address:** 200 WINSTON DR APT 119, Cliffside Park, NJ 07010-3209
- **Phone:** (617) 620-2137
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Physical Therapist in Private Practice) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 18, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1003064452) · Data from the CMS NPPES public registry.