Individual provider Active NPI

Jacquelen Borja, DPT

  • Physical Therapist
  • White Plains, NY
National Provider Identifier
1063257160
Registry record updated Jul 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
045682 Issued in NY
Practice address
317 North St
White Plains, NY 10605-2209
Phone
(914) 597-4109
NPI assigned
Jun 28, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2024

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 045682 NY Primary

Addresses

Primary practice location

317 North St
White Plains, NY 10605-2209

Mailing address

64 Centre Ave
New Rochelle, NY 10801-7468
Phone (732) 215-9195

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240731001861 NY Practitioner - Physical Therapist in Private Practice 3375080039 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

175 Memorial Hwy
New Rochelle, NY 10801-5635
Phone (914) 235-5354

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Metro Physical Occupational Speech Massage Therapy & Acupuncture PLLC Physical Therapist CurrentSince Jul 22, 2024 Accepting new patients
Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Pathology, PLLC Physical Medicine & Rehabilitation CurrentSince Oct 1, 2024 Accepting new patients
Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Path Physical Therapist CurrentSince Oct 1, 2024 Accepting new patients

Locations

4080 Hempstead Tpke
Bethpage, NY 11714
Phone (516) 738-4844

800 E Gate Blvd
Garden City, NY 11530

50 Glen Cove Rd
Greenvale, NY 11548
Phone (516) 200-3545

550 Mamaroneck Ave
Ste 104
Harrison, NY 10528
Phone (914) 777-3737

175 Memorial Hwy
Ste 2-3
New Rochelle, NY 10801
Phone (914) 235-5354

11701 84th Ave
Richmond Hill, NY 11418
Phone (718) 441-0300

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1719532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1063257160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 CENTRE AVE",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108017468",
            "telephone_number": "732-215-9195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 NORTH ST",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106052209",
            "telephone_number": "914-597-4109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORJA",
        "first_name": "JACQUELEN",
        "name_prefix": "Mrs.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-28",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "045682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in White Plains, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2024; 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.