Kenneth P Fahy, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA01453900 Issued in NJ

Practice address

4302 Klimek PL
South Amboy, NJ 08879-2942

Phone

(732) 925-7397

NPI assigned

Sep 20, 2012

Last updated

Jun 15, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Beam Chiropractic Health CenterGroup PAC ID 9537469473, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Beam Chiropractic Health Center

  • Chiropractor
  • Howell, NJ
  • NPI 1114066826
  Medicare reassignment Care Compare group NPD
• Easy PT LLC

  • Physical Therapist
  • South Amboy, NJ
  • NPI 1710590294
  Authorized official Same address or phone

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

{
    "created_epoch": "1348099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592179200000",
    "number": "1063763852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4302 KLIMEK PL",
            "city": "SOUTH AMBOY",
            "state": "NJ",
            "postal_code": "088792942",
            "telephone_number": "732-925-7397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4302 KLIMEK PL",
            "city": "SOUTH AMBOY",
            "state": "NJ",
            "postal_code": "088792942",
            "telephone_number": "732-925-7397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAHY",
        "first_name": "KENNETH",
        "middle_name": "P",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-09-20",
        "last_updated": "2020-06-15",
        "certification_date": "2020-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01453900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Easter Seals New Jersey
• Easter Seals New Jersey
• Eastern Dental of Old Bridge, LLC
• Easy PT LLC
• Leonard M Estrada, LCSW
• Favor Foot and Ankle Podiatry PC
• Eliza Brittni Ferrer, PT
• First Healthcare LLC (South Amboy Adult Day Health Care Center)
• Flexaid Support Services LLC
• Forever Doula Inc

• Physical Therapist in South Amboy, NJ
• Providers in South Amboy, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2020; 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.