MR. EBENEZER OGUNTUASE (RPT) – Physical Therapist, NPI 1619942695

MR. EBENEZER OGUNTUASE (RPT) is a healthcare provider. based in Vineland, New Jersey. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials RPT. They hold a License No. 40QA00598500 (NJ). The NPI Number for MR. EBENEZER OGUNTUASE (RPT) is 1619942695

Main info

Male
Sole Proprietor
39 Years Of Experience
Accepts Medicare Assignment
Name
MR. EBENEZER OGUNTUASE (RPT)
NPI
1619942695
Phone
(856) 794-2100
Address
611 E LANDIS AVE
Enumeration Date
22 February 2006
Last Update Date
11 May 2011

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8567942100
Graduation Year
1987 (39 years ago)
PAC ID
3274527205
Professional Enrollment ID
I20050729000850
Address ID
NJ083608017VI500XXAVEX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

4,923 PHYSICAL THERAPIST IN PRIVATE PRACTICE in NJ

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Provider Addresses for MR. EBENEZER OGUNTUASE (RPT)

  • 611, Landis Avenue, Vineland, Cumberland County, New Jersey, 08360, United States

    VINELAND, NJ 083608004

    Phone: (856) 794-2100

    Fax: (856) 794-2120

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2005-07-29

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20050729000850IPhysical Therapist In Private PracticeNJTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 08360)

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Reviews

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Frequently asked questions

Does MR. EBENEZER OGUNTUASE (RPT) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — MR. EBENEZER OGUNTUASE (RPT) uses 1619942695.
Is MR. EBENEZER OGUNTUASE (RPT) listed as active for patients and plans?
The listing shows MR. EBENEZER OGUNTUASE (RPT) as active in the NPI system.
What taxonomy line describes MR. EBENEZER OGUNTUASE (RPT)?
For research purposes, treat MR. EBENEZER OGUNTUASE (RPT) as Physical Therapist in this dataset. Clinical services aligned with this taxonomy classification.
Does MR. EBENEZER OGUNTUASE (RPT) list a practice location?
Patients near Vineland, New Jersey may find MR. EBENEZER OGUNTUASE (RPT) in results; validate coverage separately.
Why does MR. EBENEZER OGUNTUASE (RPT) have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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