Individual provider Active NPI

Keith M. Scott, PT, MPT

  • Physical Therapist
  • Whippany, NJ
National Provider Identifier
1083776918
Registry record updated Jan 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA00750300 Issued in NJ
Practice address
565 Route 10
Whippany, NJ 07981-1513
Phone
(201) 572-1012
NPI assigned
Dec 15, 2006
Last updated
Jan 3, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2019

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 40QA00750300 NJ Primary

Addresses

Primary practice location

565 Route 10
Whippany, NJ 07981-1513

Mailing address

15 Bunker Hill PL
Whippany, NJ 07981-2216
Phone (201) 572-1012

Other identifiers 1

IdentifierTypeStateIssuer
10669911OtherCAQH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081216000465 NJ Practitioner - Physical Therapist in Private Practice 0749342376 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ivyrehab Network IncGroup PAC ID 3476539776, 658 clinicians

Practice addresses (Care Compare)

187 Columbia Tpke
Florham Park, NJ 07932-1313
Phone (540) 421-9249

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ivyrehab Network Inc. Physical Therapist CurrentSince Jun 27, 2022 Accepting new patients
Trinity Rehab Somerset PA Physical Therapist Current Accepting new patients
Trinity Rehab Somerset PA CurrentSince Apr 1, 2019 Accepting new patients
Trinity Rehab Somerset PA CurrentSince Apr 1, 2019 Accepting new patients
Ivyrehab Network, Inc. Physical Therapist CurrentSince Jun 27, 2022 Accepting new patients
Liberty Physical Therapy PC Physical Therapist CurrentSince Aug 12, 2020 Accepting new patients
Hanover Orthopedic & Sports Physical Therapy, LLC Physical Therapist Past Accepting new patients

Locations

187 Columbia Tpke
Florham Park, NJ 07932
Phone (973) 377-5655

454 Passaic St
Hackensack, NJ 07601
Phone (201) 488-7905

115 Christopher Columbus Dr
Ste 300
Jersey City, NJ 07302
Phone (201) 366-1115

328 Newman Springs Rd
Ste 10
Red Bank, NJ 07701

175 Route 37 W
#R
Toms River, NJ 08755

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546473600000",
    "number": "1083776918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 BUNKER HILL PL",
            "city": "WHIPPANY",
            "state": "NJ",
            "postal_code": "079812216",
            "telephone_number": "201-572-1012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "565 ROUTE 10",
            "city": "WHIPPANY",
            "state": "NJ",
            "postal_code": "079811513",
            "telephone_number": "201-572-1012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "KEITH",
        "middle_name": "M.",
        "name_prefix": "Mr.",
        "credential": "PT, MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-15",
        "last_updated": "2019-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA00750300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "10669911",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Whippany, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2019; 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.