Ajay S Mampilly

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

40QB00300600 Issued in NJ

Practice address

100 Kinderkamack Rd
Emerson, NJ 07630-1828

Phone

(888) 493-6415

NPI assigned

Aug 22, 2013

Sex

Male

Sole proprietor

No

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 NY, NJ2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jag-One Physical Therapy LLCGroup PAC ID 2769584325, 334 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 and National Provider Directory roles.

• Jag-One Physical Therapy, LLC

  • Physical Therapist
  • West Orange, NJ
  • NPI 1518017144
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1377129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377129600000",
    "number": "1073947321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 ROLLINSON ST",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070524625",
            "telephone_number": "973-517-2094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 KINDERKAMACK RD",
            "city": "EMERSON",
            "state": "NJ",
            "postal_code": "076301828",
            "telephone_number": "888-493-6415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAMPILLY",
        "first_name": "AJAY",
        "middle_name": "S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-22",
        "last_updated": "2013-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NJ",
            "license": "40QB00300600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Inna Valentina Litrovnik, LCSW
• Local Infusion Health of NJ PC
• Dennis J Long, D.C.
• Maguire Psychiatry LLC
• Yousaf Mahmood, M.D.
• Stephen J Margulis, MD
• Ofra Markowitz, MA, LCSW
• Robert T. Martini, D.D.S.
• Frank Louis Mastrianno, MD
• Julie W McConnell, MD

• Physical Therapy Assistant in Emerson, NJ
• Providers in Emerson, NJ by specialty
• Physical Therapy Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2013; 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.