EDGE WELLNESS AND PHYSICAL THERAPY, LLC
NPI 1780254862
Physical Medicine & Rehabilitation - Sports Medicine in Fort Lee, NJ

Q: What is Edge Wellness And Physical Therapy, LLC's specialty?

The primary specialty registered for this NPI is Physical Medicine & Rehabilitation, specializing in Sports Medicine, with taxonomy code 2081S0010X.

Active since June 30, 2021

2 EXECUTIVE DR STE C1, FORT LEE, NJ 07024(201) 785-7486(201) 771-3024 Get Directions Write a Review

NPPES record last updated: June 30, 2021. Verified against the NPPES registry weekly; last sync: November 08, 2026.

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About Edge Wellness And Physical Therapy, Llc NPPES

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

EDGE WELLNESS AND PHYSICAL THERAPY, LLC (NPI 1780254862) is a healthcare organization registered as a sports medicine in Fort Lee, New Jersey and active in the NPI registry since June 2021. The organization lists Lawrence Kim, Ceo, as its authorized official.

NPPES Registry Identity

NPI1780254862

Entity TypeOrganization

Primary Taxonomy2081S0010X

Legal Business NameEDGE WELLNESS AND PHYSICAL THERAPY, LLC

Location Address2 EXECUTIVE DR STE C1Fort Lee, NJ 07024-3308

Mailing Address80 E Rte 4 Ste 100Paramus, NJ 07652-2647 · (201) 845-3000 · Fax (201) 843-2035

Phone(201) 785-7486

Fax(201) 771-3024

Organization SubpartNo

Authorized OfficialLawrence KimCeo · (201) 785-7486

Enumeration DateJune 30, 2021

NPPES CertifiedJune 30, 2021

✔ NPI 1780254862 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysical Medicine & Rehabilitation · Sports MedicineAllopathic & Osteopathic Physicians

Taxonomy Code2081S0010X

Definition

A physician who specializes in Sports Medicine is responsible for continuous care related to the enhancement of health and fitness as well as the prevention of injury and illness. The specialist possesses knowledge and experience in the promotion of wellness and the prevention of injury from many areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation and injuries. It is the goal of a Sports Medicine specialist to improve the healthcare of the individual engaged in physical exercise.

Also ListedClinic/Center · Physical TherapyTaxonomy 261QP2000X

2 EXECUTIVE DR STE C1, Fort Lee, NJ 07024

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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)

Edge Wellness And Physical Therapy, Llc 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 Edge Wellness And Physical Therapy, LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Lawrence Kim, DPT

Physical Therapist in Private Practice

NPI 1154755288

53 HENRY ST
Elmwood Park, NJ 07407

(201) 783-2332

✔ Accepts Medicare7.5 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 Edge Wellness And Physical Therapy, LLC's NPI number?

The NPI number for Edge Wellness And Physical Therapy, LLC is 1780254862. It was assigned to this organization in the NPPES registry on June 30, 2021.

Where is Edge Wellness And Physical Therapy, LLC located?

Edge Wellness And Physical Therapy, LLC is located at 2 Executive Dr Ste C1, Fort Lee, NJ 07024. The listed phone number is (201) 785-7486.

What is Edge Wellness And Physical Therapy, LLC's specialty?

The primary specialty registered for this NPI is Physical Medicine & Rehabilitation, specializing in Sports Medicine, with taxonomy code 2081S0010X.

Is Edge Wellness And Physical Therapy, LLC enrolled in Medicare?

Yes. Edge Wellness And Physical Therapy, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Edge Wellness And Physical Therapy, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Physical Therapist in Private Practice) reassigns their Medicare billing to Edge Wellness And Physical Therapy, 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Edge Wellness And Physical Therapy, LLC was last updated on June 30, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years 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.