Individual provider Active NPI

Jennifer Egle Gentile

  • Physical Therapist
  • Edgewater, NJ
National Provider Identifier
1073601423
Registry record updated Jun 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
725 River Rd Ste 60
Edgewater, NJ 07020-1149
Phone
(917) 582-3931
NPI assigned
Oct 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2022

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 Primary

Addresses

Primary practice location

725 River Rd Ste 60
Edgewater, NJ 07020-1149

Mailing address

359 W Passaic Ave
Bloomfield, NJ 07003-5521
Phone (917) 348-8651

Other names 1

  • Jennifer Egle Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
023489NYMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Jennifer Gentile Physical Therapy LLC Physical Therapist CurrentSince Jun 12, 2022 Accepting new patients
Maureen Broderick Wilhelm LPT PA Physical Therapist PastSince Jun 1, 2004 Accepting new patients
New York Orthopaedic Hospital Associates, PC Past Accepting new patients
Trustees of Columbia University in the City of New York Past Accepting new patients

Locations

725 River Rd
Ste 60
Edgewater, NJ 07020
Phone (201) 833-7213

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": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654560000000",
    "number": "1073601423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "359 W PASSAIC AVE",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070035521",
            "telephone_number": "917-348-8651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 RIVER RD STE 60",
            "city": "EDGEWATER",
            "state": "NJ",
            "postal_code": "070201149",
            "telephone_number": "917-582-3931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENTILE",
        "first_name": "JENNIFER",
        "middle_name": "EGLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-11",
        "last_updated": "2022-06-07",
        "certification_date": "2022-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "EGLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Edgewater, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.