Individual provider Active NPI

Peter Woghiren, DPT

  • Physical Therapist
  • Basking Ridge, NJ
National Provider Identifier
1154831287
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01731800 Issued in NJ
Practice address
25 Mountainview Blvd Ste 207
Basking Ridge, NJ 07920-3453
Phone
(908) 758-1006
Fax
(908) 360-0511
NPI assigned
Oct 3, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 40QA01731800 NJ Primary

Addresses

Primary practice location

25 Mountainview Blvd Ste 207
Basking Ridge, NJ 07920-3453

Mailing address

25 Mountainview Blvd Ste 207
Basking Ridge, NJ 07920-3453
Phone (908) 758-1006

Other identifiers 1

IdentifierTypeStateIssuer
40QA01731800OtherNJNJ LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171127000292 NJ Practitioner - Physical Therapist in Private Practice 4688931884 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1130 Route 202
Suite E7
Raritan, NJ 08869-1444
Phone (908) 758-0770

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA01731800NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Chiropractic and Rehabilitation Center of Morris, LLC CurrentSince May 1, 2019 Accepting new patients
Riverwalk Physical Therapy, LLC Physical Therapist CurrentSince Sep 1, 2017 Accepting new patients
Gear in Physical Therapy LLC Current Accepting new patients

Locations

25 Mountainview Blvd
Ste 207
Basking Ridge, NJ 07920
Phone (908) 758-1006

210 Malapardis Rd
Ste 203
Cedar Knolls, NJ 07927
Phone (862) 260-9656

7 Ridgedale Ave
Ste 203
Cedar Knolls, NJ 07927
Phone (973) 359-4400

Organizations & group practices 4

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": "1506988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1154831287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 MOUNTAINVIEW BLVD STE 207",
            "city": "BASKING RIDGE",
            "state": "NJ",
            "postal_code": "079203453",
            "telephone_number": "908-758-1006",
            "fax_number": "908-360-0511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 MOUNTAINVIEW BLVD STE 207",
            "city": "BASKING RIDGE",
            "state": "NJ",
            "postal_code": "079203453",
            "telephone_number": "908-758-1006",
            "fax_number": "908-360-0511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOGHIREN",
        "first_name": "PETER",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-03",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01731800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NJ LICENSE",
            "identifier": "40QA01731800",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Basking Ridge, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.