Dr Michael Formisano, PT, DPT, OCS in Teaneck, NJ - Medicare Physical Therapist Provider

Dr Michael Formisano, PT, DPT, OCS is a medicare enrolled "Physical Therapist" provider in Teaneck, New Jersey. His current practice location is 1029 Teaneck Rd Ste 2e, Teaneck, New Jersey. You can reach out to his office (for appointments etc.) via phone at (551) 246-9340.

Dr Michael Formisano is licensed to practice in New Jersey (license number 40QA01081900) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1902029242.

Contact Information

	Dr Michael Formisano, PT, DPT, OCS
	1029 Teaneck Rd Ste 2e, Teaneck, NJ 07666-4514
	(551) 246-9340
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Dr Michael Formisano
Gender	Male
Speciality	Physical Therapist
Location	1029 Teaneck Rd Ste 2e, Teaneck, New Jersey
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1902029242
Provider Enumeration Date: 04/11/2007
Last Update Date: 07/14/2023

Medicare PECOS Information:

PECOS PAC ID: 4183722903
Enrollment ID: I20231127000663

Medical Identifiers

Medical identifiers for Dr Michael Formisano such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1902029242	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
225100000X	Physical Therapist	40QA01081900 (New Jersey)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Michael Formisano allows following entities to bill medicare on his behalf.

Provider Name	Optimal Form & Function Llc
Provider Type	Part B Supplier - Physical/occupational Therapy Group In Private Practice
Provider Identifiers	NPI Number: 1194402180 PECOS PAC ID: 8123476553 Enrollment ID: O20231127000578

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Michael Formisano is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Dr Michael Formisano, PT, DPT, OCS 3-18 Virginia Dr, Fair Lawn, NJ 07410-4727 Ph: (201) 887-2409	Dr Michael Formisano, PT, DPT, OCS 1029 Teaneck Rd Ste 2e, Teaneck, NJ 07666-4514 Ph: (551) 246-9340

Reviews and Comments

Physical Therapist in Teaneck, NJ

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Dr Michael Formisano, PT, DPT, OCS - Medicare Physical Therapist in Teaneck, NJ