Organization Active NPI

K2 Physical Therapy LLC

  • Physical Therapist
  • Ho Ho Kus, NJ
National Provider Identifier
1104535673
Registry record updated Jul 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
K2 PHYSICAL THERAPY LLC
Practice address
10 Dogwood LN
Ho Ho Kus, NJ 07423-1653
Phone
(201) 230-2357
NPI assigned
Nov 23, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Brendan John Kirk, DPTNPI 1285067470
Title
Owner
Phone
(201) 230-2357

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

10 Dogwood LN
Ho Ho Kus, NJ 07423-1653

Mailing address

10 Dogwood LN
Ho Ho Kus, NJ 07423-1653

Other identifiers 1

IdentifierTypeStateIssuer
0991759MedicaidNJ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230301000045 NJ Part B Supplier - Physical/Occupational Therapy Group in Private Practice 7618340357 Receives reassigned benefits from 8 practitioners
Practice locations: West Ramsey, NJ

National Provider Directory

National Provider Directory

Locations

245 E Main St
Lowr
Ramsey, NJ 07446
Phone (551) 308-5355

245 E Main St
Ste 7
Ramsey, NJ 07446

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1669161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721865600000",
    "number": "1104535673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 DOGWOOD LN",
            "city": "HO HO KUS",
            "state": "NJ",
            "postal_code": "074231653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 DOGWOOD LN",
            "city": "HO HO KUS",
            "state": "NJ",
            "postal_code": "074231653",
            "telephone_number": "201-230-2357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "K2 PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-23",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A",
        "authorized_official_last_name": "KIRK",
        "authorized_official_first_name": "BRENDAN",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-230-2357",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0991759",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ho Ho Kus, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare 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.