Individual provider Active NPI

Jeffrey Fitzgerald, PT

  • Physical Therapist
  • Berkeley Heights, NJ
National Provider Identifier
1053460444
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA00847100 Issued in NJ
Practice address
391 Springfield Ave
Suite 2a
Berkeley Heights, NJ 07922-1174
Phone
(908) 898-1950
Fax
(908) 898-1960
NPI assigned
Jan 9, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 40QA00847100 NJ Primary

Addresses

Primary practice location

391 Springfield Ave
Suite 2a
Berkeley Heights, NJ 07922-1174

Mailing address

90 Meyersville Rd
Chatham, NJ 07928-1169
Phone (973) 701-1449

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050331000009 NJ Practitioner - Physical Therapist in Private Practice 4183671381 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

415 Springfield Ave
Berkeley Heights, NJ 07922-1108
Phone (908) 898-1950

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mountainside Physical Therapy LLC Physical Therapist CurrentSince May 18, 2020 Accepting new patients
Berkeley Heights Physical Therapy, LLC Physical Therapist CurrentSince Apr 1, 2006 Accepting new patients
Basking Ridge Physical Therapy, LLC Physical Therapist PastSince Sep 4, 2012 Accepting new patients
Peter Barnett & Howard J Phillips Physical Therapist Past Accepting new patients

Locations

415 Springfield Ave
Berkeley Hts, NJ 07922
Phone (908) 898-1950

1450 Route 22
Ste 201
Mountainside, NJ 07092
Phone (908) 264-7941

Organizations & group practices 4

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": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053460444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 MEYERSVILLE RD",
            "city": "CHATHAM",
            "state": "NJ",
            "postal_code": "079281169",
            "telephone_number": "973-701-1449",
            "fax_number": "973-701-0742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "391 SPRINGFIELD AVE",
            "address_2": "SUITE 2A",
            "city": "BERKELEY HEIGHTS",
            "state": "NJ",
            "postal_code": "079221174",
            "telephone_number": "908-898-1950",
            "fax_number": "908-898-1960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZGERALD",
        "first_name": "JEFFREY",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA00847100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley Heights, NJ

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.
  • 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.