Individual provider Active NPI

Jaison Thomas

  • Physical Therapist
  • Jersey City, NJ
National Provider Identifier
1023197746
Registry record updated Jun 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA010632 Issued in NJ
Practice address
364 Ege Ave
Jersey City, NJ 07304-1015
Phone
(201) 854-6700
NPI assigned
Nov 3, 2006
Last updated
Jun 17, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2008

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 40QA010632 NJ Primary

Addresses

Primary practice location

364 Ege Ave
Jersey City, NJ 07304-1015

Mailing address

364 Ege Avenue
Jersey City, NJ 07304

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040902000484 NJ Practitioner - Physical Therapist in Private Practice 9133195043 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sportscare of America, PCGroup PAC ID 9032213756, 132 clinicians

Practice addresses (Care Compare)

902 Oak Tree Ave
Suite 500
South Plainfield, NJ 07080-5139
Phone (201) 583-6900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA010632NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sportscare of America, PC Physical Therapist CurrentSince Jan 10, 2007 Accepting new patients
United Sports Care & Physical Therapy Physical Therapist CurrentSince Sep 6, 2011 Accepting new patients
Sportscare Institute, Inc. Physical Therapist Past Accepting new patients

Locations

47 S Washington Ave
Bergenfield, NJ 07621
Phone (201) 384-2525

1161 Burnt Tavern Rd
Brick, NJ 08724
Phone (732) 458-1255

317 Brick Blvd
Ste 120
Brick, NJ 08723
Phone (732) 255-9500

197 Ridgedale Ave
Cedar Knolls, NJ 07927
Phone (973) 292-0700

11 Eagle Rock Ave
Fl 2
East Hanover, NJ 07936
Phone (973) 887-3000

8901 Kennedy Blvd
North Bergen, NJ 07047
Phone (201) 758-1001

1 W Ridgewood Ave
Ste 104
Paramus, NJ 07652
Phone (201) 652-1415

140 N Route 17
Ste 272
Paramus, NJ 07652
Phone (201) 261-4343

867 Saint Georges Ave
Ste 3
Rahway, NJ 07065
Phone (732) 428-4008

80 Oak Hill Rd
Red Bank, NJ 07701
Phone (732) 741-2313

902 Oak Tree Ave
Ste 500
South Plainfield, NJ 07080
Phone (201) 583-6900

530 Lakehurst Rd
Ste 202204
Toms River, NJ 08755
Phone (732) 349-1201

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213660800000",
    "number": "1023197746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "364 EGE AVENUE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "07304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "364 EGE AVE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073041015",
            "telephone_number": "201-854-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "JAISON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-03",
        "last_updated": "2008-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA010632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jersey City, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2008; 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.