Beth A. Smith, P.T. – Physical Therapist

Key facts

NPI: 1083774590
Entity type: Individual (NPI type 1)
Primary specialty: Physical Therapist 225100000X
License: 40QA00418600 (NJ)
Practice address: 700 Passaic Ave
West Caldwell, NJ 07006-6408
Phone: (973) 575-7576
NPI assigned: Dec 12, 2006
Sex: Female
Sole proprietor: No

Organizations & group practices 1

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.

Ippolito Rehabilitation, LLC Physical Therapist · Naples, FL · NPI 1386140754

Medicare reassignment NPD FL · PHYSICAL THERAPIST

Medicare participation

Medicare fee-for-service enrollment: Enrolled in FL

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20210226000094	FL	Practitioner - Physical Therapist in Private Practice	1759557747	Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD): Yes

State licenses

License	State	Type	Specialty
40QA00418600	NJ	MD	Physical Therapist

Practice roles

Organization	Specialty	Status	New patients
Ippolito Rehabilitation, LLC	Physical Therapist	Current since Jan 17, 2021	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Physical Therapist	225100000X	40QA00418600	NJ	Yes

Addresses

Primary practice location

700 Passaic Ave
West Caldwell, NJ 07006-6408

Mailing address

83 Park Ave
Caldwell, NJ 07006-4943
Phone (973) 403-3431

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 8, 2010.

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278547200000",
    "number": "1083774590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "83 PARK AVE",
            "city": "CALDWELL",
            "state": "NJ",
            "postal_code": "070064943",
            "telephone_number": "973-403-3431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 PASSAIC AVE",
            "city": "WEST CALDWELL",
            "state": "NJ",
            "postal_code": "070066408",
            "telephone_number": "973-575-7576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "BETH",
        "middle_name": "A.",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-12",
        "last_updated": "2010-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA00418600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Caldwell, NJ

All providers in West Caldwell, NJ · Physical Therapist in New Jersey

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2010. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider 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.