Individual provider Active NPI

Trung M Le

  • Physical Therapist
  • West Caldwell, NJ
National Provider Identifier
1003325697
Registry record updated Sep 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA016824000 Issued in NJ
Practice address
165 Fairfield Ave
West Caldwell, NJ 07006-6414
Phone
(973) 226-1100
NPI assigned
Sep 26, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 40QA016824000 NJ Primary

Addresses

Primary practice location

165 Fairfield Ave
West Caldwell, NJ 07006-6414

Mailing address

3379 Route 46 Apt 10D
Parsippany, NJ 07054-1259

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180501000165 NJ Practitioner - Physical Therapist in Private Practice 7416211313 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sportsmed PT LLCGroup PAC ID 0749535805, 183 clinicians

Practice addresses (Care Compare)

211 Berdan Ave
Wayne, NJ 07470-3236
Phone (201) 249-6930

266 Harristown Rd
Suite 200
Glen Rock, NJ 07452-3354
Phone (201) 445-7000

784 Franklin Ave
Suite 230
Franklin Lakes, NJ 07417-1306
Phone (201) 891-0090

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA016824000NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sportsmed PT LLC Physical Therapist CurrentSince May 9, 2018 Accepting new patients

Locations

784 Franklin Ave
Ste 230
Franklin Lks, NJ 07417
Phone (201) 891-0090

266 Harristown Rd
Ste 108
Glen Rock, NJ 07452

266 Harristown Rd
Ste 304
Glen Rock, NJ 07452
Phone (201) 345-5798

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1506384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506384000000",
    "number": "1003325697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3379 ROUTE 46 APT 10D",
            "city": "PARSIPPANY",
            "state": "NJ",
            "postal_code": "070541259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 FAIRFIELD AVE",
            "city": "WEST CALDWELL",
            "state": "NJ",
            "postal_code": "070066414",
            "telephone_number": "973-226-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LE",
        "first_name": "TRUNG",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-26",
        "last_updated": "2017-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA016824000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Caldwell, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.