Individual provider Active NPI

Irm Choudary

  • Physical Therapy Clinic/Center
  • Old Bridge, NJ
National Provider Identifier
1154023240
Registry record updated Mar 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
40QA02159400 Issued in NJ
Practice address
254 Texas Rd
Old Bridge, NJ 08857-4008
Phone
(732) 561-3402
NPI assigned
Mar 21, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 40QA02159400 NJ Primary

Addresses

Primary practice location

254 Texas Rd
Old Bridge, NJ 08857-4008

Mailing address

4 Kent CT
Princeton, NJ 08540-6116
Phone (917) 930-0373

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230413001272 NJ Practitioner - Physical Therapist in Private Practice 0840665451 Reassigns benefits to 2 organizations
I20240124002536 NY Practitioner - Physical Therapist in Private Practice 0840665451 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Nova Southeastern College of Osteo Medicine, 2022
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)

15 S Kinderkamack Rd
Montvale, NJ 07645-2112
Phone (201) 573-4969

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
051757NYMDPharmacist
40QA02159400NJMDPhysical Therapy Clinic/Center

Practice roles

OrganizationSpecialtyStatusNew patients
Jag-One Physical Therapy, LLC Physical Therapy CurrentSince Mar 30, 2023 Accepting new patients
Ivyrehab Network Inc. Current Accepting new patients
Ivyrehab Network Inc CurrentSince Apr 22, 2024 Accepting new patients
Ivyrehab Network, Inc. CurrentSince Apr 22, 2024 Accepting new patients
RB Physical and Occupational Therapy PLLC CurrentSince Dec 11, 2023 Accepting new patients

Locations

981 US Highway 22
Bridgewater, NJ 08807
Phone (908) 231-0511

981 US Highway 22
Fl 2
Bridgewater, NJ 08807
Phone (908) 231-0511

731 Lacey Rd
Ste 3
Forked River, NJ 08731
Phone (609) 242-6780

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

15 S Kinderkamack Rd
Montvale, NJ 07645
Phone (201) 573-4969

254 Texas Rd
Old Bridge, NJ 08857
Phone (732) 359-2691

221 Rockingham Row
Princeton, NJ 08540
Phone (609) 580-1520

622 Eagle Rock Ave
West Orange, NJ 07052
Phone (973) 669-0078

4013 Avenue U
Brooklyn, NY 11234
Phone (718) 692-0949

704 Executive Blvd
Ste H
Valley Cottage, NY 10989
Phone (845) 268-7800

Organizations & group practices 5

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": "1679356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679356800000",
    "number": "1154023240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 KENT CT",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085406116",
            "telephone_number": "917-930-0373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "254 TEXAS RD",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "088574008",
            "telephone_number": "732-561-3402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOUDARY",
        "first_name": "IRM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-21",
        "last_updated": "2023-03-21",
        "certification_date": "2023-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NJ",
            "license": "40QA02159400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Old Bridge, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2023; 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.