Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Andrew Atalla

Individual provider Physical Therapy Assistant · NPI 1295134468

Andrew Atalla is a Physical Therapist in Private Practice in West Orange, New Jersey. Qualified in 2018, 8 years ago. Practices with Jag-One Physical Therapy LLC, a 328-clinician group and accepts Medicare assignment. Licensed in New Jersey.

Years since qualifying
8
Licensed in
NJ
In the registry since
2014
Specialties on file
2

Practice location Address checks out

622 Eagle Rock Ave Suit 104
West Orange, NJ 07052-2994
Phone: (973) 669-0078
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 40QA01805500 (NJ)
Physical Therapy Assistant Taxonomy 225200000X · Licence 40QB00311300 (NJ)

Record details

NPI number1295134468
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedAugust 13, 2014
Last updated in NPPESFebruary 13, 2020
Certification dateFebruary 13, 2020
Mailing address622 Eagle Rock Ave, Suit 104, West Orange, NJ 07052-2994

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Jag-One Physical Therapy Llc — 328 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in West Orange