REJUVENATIVE WELLNESS LLC
NPI 1164240156
Clinic/Center - Multi-Specialty in Fort Lee, NJ

Q: What is Rejuvenative Wellness LLC's NPI number?

The NPI number for Rejuvenative Wellness LLC is 1164240156. It was assigned to this organization in the NPPES registry on September 30, 2024. The provider is doing business as Ishitani Health Center.

Q: What is Rejuvenative Wellness LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.

Active since September 30, 2024

1600 PARKER AVE STE 1, FORT LEE, NJ 07024(201) 302-9993(201) 302-9994 Get Directions Write a Review

NPPES record last updated: April 26, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Rejuvenative Wellness Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

REJUVENATIVE WELLNESS LLC (NPI 1164240156), doing business as Ishitani Health Center, is a healthcare organization registered as a multi-specialty in Fort Lee, New Jersey and active in the NPI registry since September 2024. The organization maintains a secondary practice location in Palisades Park and lists Roger Mitchell, Owner, as its authorized official.

NPPES Registry Identity

NPI1164240156

Entity TypeOrganization

Primary Taxonomy261QM1300X

Legal Business NameREJUVENATIVE WELLNESS LLC

Location Address1600 PARKER AVE STE 1Fort Lee, NJ 07024-7050

Mailing Address117 Morningside Lane, Unit APalisades Park, NJ 07650 · (917) 690-4730

Phone(201) 302-9993

Fax(201) 302-9994

Organization SubpartNo

Authorized OfficialRoger MitchellOwner · (917) 690-4730

Enumeration DateSeptember 30, 2024

Last NPPES UpdateApril 26, 2025

NPPES CertifiedApril 26, 2025

✔ NPI 1164240156 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Multi-SpecialtyAmbulatory Health Care Facilities

Taxonomy Code261QM1300X

Also ListedChiropractorTaxonomy 111N00000X

1600 PARKER AVE STE 1, Fort Lee, NJ 07024

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Other Names 1

Doing Business AsIshitani Health Center

Secondary Practice Location 1

Location 1117 Morningside Lane, Unit APalisades Park, NJ 07650 · Phone (917) 690-4730

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Rejuvenative Wellness Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 4 clinicians reassign Medicare billing to Rejuvenative Wellness LLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 2 within 10 miles. They are listed nearest first.

Clinicians, nearest first (4)

Sun Park, DC

Chiropractic

NPI 1801326152

1600 PARKER AVE STE 1
Fort Lee, NJ 07024

(908) 578-9375

✔ Accepts MedicareSame address

Yoonho Shin, DC

Chiropractic

NPI 1326671363

31 E 32ND ST
New York, NY 10016

(917) 525-4345

✔ Accepts Medicare7.1 mi

Roger Mitchell, DC

Chiropractic

NPI 1326562034

7 WALNUT RD
Glen Cove, NY 11542

(516) 609-3100

✔ Accepts Medicare18 mi

Sophia Ma, DPT

Physical Therapist in Private Practice

NPI 1568828598

800 E GATE BLVD
Garden City, NY 11530

(516) 745-8070

✔ Accepts Medicare20 mi

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 Rejuvenative Wellness LLC's NPI number?

The NPI number for Rejuvenative Wellness LLC is 1164240156. It was assigned to this organization in the NPPES registry on September 30, 2024. The provider is doing business as Ishitani Health Center.

Where is Rejuvenative Wellness LLC located?

Rejuvenative Wellness LLC is located at 1600 Parker Ave Ste 1, Fort Lee, NJ 07024. The listed phone number is (201) 302-9993.

What is Rejuvenative Wellness LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.

Is Rejuvenative Wellness LLC enrolled in Medicare?

Yes. Rejuvenative Wellness LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Rejuvenative Wellness LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians in 2 Medicare specialties reassign their Medicare billing to Rejuvenative Wellness LLC. 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. The largest specialties are Chiropractic (3) and Physical Therapist in Private Practice (1). Of these, 1 practice at this address and 2 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Rejuvenative Wellness LLC was last updated on April 26, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.