Active NPI
Jay R Hartigan, PT
- Physical Therapist
- Palm Beach Gardens, FL
National Provider Identifier
1053407502
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 6644
- Practice address
- 11380 Prosperity Farms Rd. Ste. B109
Palm Beach Gardens, FL 33410 - Phone
- (561) 803-7761
- Fax
- (561) 803-7762
- NPI assigned
- Oct 4, 2006
- 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 Therapist | 225100000X | 6644 | FL | Primary |
Addresses
Primary practice location
11380 Prosperity Farms Rd. Ste. B109
Palm Beach Gardens, FL 33410
Mailing address
18165 125TH Ave. North
Jupiter, FL 33478
Phone (561) 707-6296
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050928000413 | FL | Practitioner - Physical Therapist in Private Practice | 4880629070 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6644 | FL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1053407502",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18165 125TH AVE. NORTH",
"city": "JUPITER",
"state": "FL",
"postal_code": "33478",
"telephone_number": "561-707-6296",
"fax_number": "561-575-5259"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11380 PROSPERITY FARMS RD. STE. B109",
"city": "PALM BEACH GARDENS",
"state": "FL",
"postal_code": "33410",
"telephone_number": "561-803-7761",
"fax_number": "561-803-7762"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARTIGAN",
"first_name": "JAY",
"middle_name": "R",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "6644",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palm Beach Gardens, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.