Jesse Christian Pedersen

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA02132700 Issued in NJ

Practice address

57 Lower Matchaponix Ave
Monroe, NJ 08831-1443

Phone

(732) 570-8598

NPI assigned

Oct 13, 2022

Last updated

Oct 13, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR, NJ2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 2022

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Apex Home Therapy LLC

  • Physical Therapist
  • Freehold, NJ
  • NPI 1861966129
  Medicare reassignment NPD
• Benchmark Physical Therapy of Oregon LLC

  • Physical Therapist
  • Grants Pass, OR
  • NPI 1801257191
  Medicare reassignment NPD
• Groundswell Rehabilitation LLC

  • Physical Therapist
  • Monroe Township, NJ
  • NPI 1063324853
  NPD (past) Authorized official
• At Home by Enhance Therapies LLC

  • Physical Therapist
  • Lakewood, NJ
  • NPI 1124603246
  NPD
• Benchmark Physical Therapy of Or, LLC

  • Physical Therapist
  • Roseburg, OR
  • NPI 1427524388
  NPD

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

{
    "created_epoch": "1665619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665619200000",
    "number": "1174249908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 LOWER MATCHAPONIX AVE",
            "city": "MONROE",
            "state": "NJ",
            "postal_code": "088311443",
            "telephone_number": "732-570-8598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 LOWER MATCHAPONIX AVE",
            "city": "MONROE",
            "state": "NJ",
            "postal_code": "088311443",
            "telephone_number": "732-570-8598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDERSEN",
        "first_name": "JESSE",
        "middle_name": "CHRISTIAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-10-13",
        "last_updated": "2022-10-13",
        "certification_date": "2022-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA02132700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shruti Satish Patel, DNP, APN-BC
• Pathways to Wellness LLC (Center For Wellness)
• Felicia M. Patten, IBCLC
• Paulus LLC (Always Best Care)
• Peaceful Change Counseling
• Pediatrician in Monroe (Hanna Gebre Medhin)
• Michelle Marie Petito, BCBA
• Mary Hazel Platon, PT
• Donald R. Polakoff, M.D.
• Heather Ponterio

• Physical Therapist in Monroe, NJ
• Providers in Monroe, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 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.