Active NPI
Justin A Soto, PTA
- Physical Therapy Assistant
- Old Bridge, NJ
National Provider Identifier
1003611641
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 40QB00420900
- Practice address
- 300 Perrine Rd Ste 315
Old Bridge, NJ 08857-3628 - Phone
- (877) 532-7837
- NPI assigned
- Feb 18, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 40QB00420900 | NJ | Primary |
Addresses
Primary practice location
300 Perrine Rd Ste 315
Old Bridge, NJ 08857-3628
Mailing address
2-22 Banta PL
Fair Lawn, NJ 07410-3058
Phone (877) 532-7837
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40QB00420900 | NJ | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1739836800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1740441600000",
"number": "1003611641",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2-22 BANTA PL",
"city": "FAIR LAWN",
"state": "NJ",
"postal_code": "074103058",
"telephone_number": "877-532-7837"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 PERRINE RD STE 315",
"city": "OLD BRIDGE",
"state": "NJ",
"postal_code": "088573628",
"telephone_number": "877-532-7837"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOTO",
"first_name": "JUSTIN",
"middle_name": "A",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-02-18",
"last_updated": "2025-02-25",
"certification_date": "2025-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "NJ",
"license": "40QB00420900",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Old Bridge, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.