Individual provider Active NPI

Brett W Melworm, MPT

  • Physical Therapist
  • Summit, NJ
National Provider Identifier
1124182191
Registry record updated Sep 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA00521000 Issued in NJ
Practice address
47 Maple St
Ste 108
Summit, NJ 07901-2571
Phone
(908) 598-9009
Fax
(908) 598-9492
NPI assigned
Dec 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2026

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 40QA00521000 NJ Primary

Addresses

Primary practice location

47 Maple St
Ste 108
Summit, NJ 07901-2571

Mailing address

12 Skyview Gardens Rd
Lebanon, NJ 08833-3208
Phone (908) 687-1830

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA00521000NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
David J Jacobs, MD PA PastSince Feb 1, 1998 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788652800000",
    "number": "1124182191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 SKYVIEW GARDENS RD",
            "city": "LEBANON",
            "state": "NJ",
            "postal_code": "088333208",
            "telephone_number": "908-687-1830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 MAPLE ST",
            "address_2": "STE 108",
            "city": "SUMMIT",
            "state": "NJ",
            "postal_code": "079012571",
            "telephone_number": "908-598-9009",
            "fax_number": "908-598-9492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELWORM",
        "first_name": "BRETT",
        "middle_name": "W",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-21",
        "last_updated": "2026-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA00521000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Summit, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2026; 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.