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Form Physical Therapy LLC

Physical Therapy Clinic/Center in West Orange, NJ · enumerated 2026 · authorized official Michael Feller, Owner/Physical Therapist.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1053254540

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Registry record

Entity type Organization (Type 2)
Legal business name Form Physical Therapy LLC
Practice address 39 Colonial Woods Dr, West Orange, NJ, 07052
Phone (732) 221-6703
Enumeration date Apr 10, 2026
Last updated in NPPES Apr 10, 2026

Taxonomy & classification

261QP2000X Physical Therapy Clinic/Center Ambulatory Health Care Facilities Primary

Authorized official

Name Michael Feller
Title Owner/Physical Therapist
Phone (732) 221-6703

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What is the NPI number for Form Physical Therapy LLC?
The NPI for Form Physical Therapy LLC is 1053254540, a Type 2 (organization) record in the CMS NPPES registry.
Who is the authorized official for Form Physical Therapy LLC?
NPPES lists Michael Feller (Owner/Physical Therapist) as the authorized official for this organization.

Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2026-04-10.