Individual provider Active NPI

Susan Medford, PT

  • Physical Therapist
  • Hazlet, NJ
National Provider Identifier
1053343657
Registry record updated Jul 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA00661800 Issued in NJ
Practice address
226 Middle Rd
Suite 5
Hazlet, NJ 07730-1945
Phone
(732) 888-9889
Fax
(732) 888-9897
NPI assigned
Jul 6, 2006
Last updated
Jul 13, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2018

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 40QA00661800 NJ Primary

Addresses

Primary practice location

226 Middle Rd
Suite 5
Hazlet, NJ 07730-1945

Mailing address

545 Route 35
Red Bank, NJ 07701-5037
Phone (973) 467-7976

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050110000266 NJ Practitioner - Physical Therapist in Private Practice 7315995065 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Joint Physical Therapy and Sports Medicine LLCGroup PAC ID 9234539552, 6 clinicians

Practice addresses (Care Compare)

150 Woodward Rd
Manalapan, NJ 07726-4102
Phone (732) 798-4545

40 Old Country Rd
Middletown, NJ 07748-1721
Phone (732) 487-2300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sea Girt Physical Medicine and Rehabilitation Associates, LLC CurrentSince Mar 1, 2020 Accepting new patients
Sportscare of America, PC Physical Therapist CurrentSince Jul 13, 2018 Accepting new patients
United Sports Care & Physical Therapy Physical Therapist CurrentSince Jul 13, 2018 Accepting new patients
Joint Physical Therapy and Sports Medicine LLC Physical Therapist CurrentSince Jun 1, 2021 Accepting new patients
Professional Orthopedic and Sports Physical Therapy Physical Therapist PastSince Jan 1, 2006 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

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

6 Main St
Madison, NJ 07940
Phone (973) 766-5580

240 Parker Ave
Manasquan, NJ 08736
Phone (732) 612-8412

545 State Route 35
Red Bank, NJ 07701
Phone (732) 758-8388

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

1945 State Route 33
Wall Township, NJ 07753
Phone (732) 776-2333

Organizations & group practices 5

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": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531440000000",
    "number": "1053343657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "545 ROUTE 35",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077015037",
            "telephone_number": "973-467-7976",
            "fax_number": "973-467-7971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "226 MIDDLE RD",
            "address_2": "SUITE 5",
            "city": "HAZLET",
            "state": "NJ",
            "postal_code": "077301945",
            "telephone_number": "732-888-9889",
            "fax_number": "732-888-9897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDFORD",
        "first_name": "SUSAN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-06",
        "last_updated": "2018-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA00661800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hazlet, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2018; 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.