Individual provider Active NPI

Jane So Santos, PT

  • Physical Therapist
  • Lincoln Park, NJ
National Provider Identifier
1093982977
Registry record updated Mar 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01280700 Issued in NJ
Practice address
499 Pine Brook Rd
Lincoln Park, NJ 07035-1804
Phone
(973) 696-3300
NPI assigned
May 10, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 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 40QA01280700 NJ Primary

Addresses

Primary practice location

499 Pine Brook Rd
Lincoln Park, NJ 07035-1804

Mailing address

100 Beechwood Dr
Wayne, NJ 07470-5612
Phone (443) 813-8366

Other practice location 1

3290 N Ridge Rd
suite 290
Ellicott City, MD 21043-3655
Phone (410) 750-9006 ext. 108

Other names 1

  • Jane Briones So 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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
40QA01280700NJMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1210377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583280000000",
    "number": "1093982977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 BEECHWOOD DR",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074705612",
            "telephone_number": "443-813-8366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "499 PINE BROOK RD",
            "city": "LINCOLN PARK",
            "state": "NJ",
            "postal_code": "070351804",
            "telephone_number": "973-696-3300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3290 N Ridge Rd",
            "address_2": "suite 290",
            "address_purpose": "LOCATION",
            "city": "Ellicott City",
            "state": "MD",
            "postal_code": "210433655",
            "country_code": "US",
            "telephone_number": "410-750-9006 x108",
            "fax_number": "410-750-0787",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANTOS",
        "first_name": "JANE",
        "middle_name": "SO",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-10",
        "last_updated": "2020-03-04",
        "certification_date": "2020-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01280700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JANE",
            "last_name": "SO",
            "middle_name": "BRIONES",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lincoln Park, NJ

Sources for this page

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