Individual provider Active NPI

Bernardo Paul Avenido Garcia, PT, DPT

  • Physical Therapist
  • Paramus, NJ
National Provider Identifier
1073118097
Registry record updated Dec 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01978700 Issued in NJ
Practice address
185 NJ-17 S
Suite 101B
Paramus, NJ 07652
Phone
(201) 560-0711
NPI assigned
Nov 30, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2020

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 40QA01978700 NJ Primary

Addresses

Primary practice location

185 NJ-17 S
Suite 101B
Paramus, NJ 07652

Mailing address

16 Morton St
Jersey City, NJ 07304-1125
Phone (201) 855-6294

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201208000538 NJ Practitioner - Physical Therapist in Private Practice 2769894229 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA01978700NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
East Coast Spine Joint and Sports Medicine CurrentSince Mar 23, 2021 Accepting new patients
Kayal Medical Group, LLC Physical Therapist CurrentSince Jan 1, 2022 Accepting new patients
Kayal Orthopaedic Center, P.C. CurrentSince Dec 4, 2020 Accepting new patients

Locations

784 Franklin Ave
Ste 250
Franklin Lks, NJ 07417
Phone (201) 560-0711

720 Monroe St
Ste C208
Hoboken, NJ 07030
Phone 20153392001005

129 Newark Ave
Jersey City, NJ 07302
Phone (201) 333-2223

185 N Route 17
Ste 101
Paramus, NJ 07652
Phone (201) 560-0711

Organizations & group practices 3

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": "1606694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607040000000",
    "number": "1073118097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 MORTON ST",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073041125",
            "telephone_number": "201-855-6294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 NJ-17 S",
            "address_2": "SUITE 101B",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "07652",
            "telephone_number": "201-560-0711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCIA",
        "first_name": "BERNARDO PAUL",
        "middle_name": "AVENIDO",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-30",
        "last_updated": "2020-12-04",
        "certification_date": "2020-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01978700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paramus, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2020; 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.

Verify at the official NPI Registry.