Individual provider Active NPI

Amanda Poulakowski

  • Physical Therapist
  • Hamilton, NJ
National Provider Identifier
1164205423
Registry record updated Aug 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
825 Route 33 Ste 2
Hamilton, NJ 08619-4421
Phone
(609) 584-4770
NPI assigned
Aug 18, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2023

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 Primary

Addresses

Primary practice location

825 Route 33 Ste 2
Hamilton, NJ 08619-4421

Mailing address

981 US Highway 22
Bridgewater, NJ 08807-2946

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231027001845 NJ Practitioner - Physical Therapist in Private Practice 7113373143 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jag-One Physical Therapy LLCGroup PAC ID 2769584325, 334 clinicians

Practice addresses (Care Compare)

622 Eagle Rock Ave
West Orange, NJ 07052-2994
Phone (973) 669-0078

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Jag-One Physical Therapy, LLC Physical Therapist CurrentSince Sep 1, 2023 Accepting new patients

Locations

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

825 Route 33
Ste 2
Hamilton, NJ 08619
Phone (609) 584-4770

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

1675 Whitehorse Mercerville Rd
Ste 101
Trenton, NJ 08619
Phone (609) 379-0900

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1692316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692316800000",
    "number": "1164205423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "981 US HIGHWAY 22",
            "city": "BRIDGEWATER",
            "state": "NJ",
            "postal_code": "088072946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 ROUTE 33 STE 2",
            "city": "HAMILTON",
            "state": "NJ",
            "postal_code": "086194421",
            "telephone_number": "609-584-4770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POULAKOWSKI",
        "first_name": "AMANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-18",
        "last_updated": "2023-08-18",
        "certification_date": "2023-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamilton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 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.