Individual provider Active NPI

Jennifer Vadas, DPT

  • Physical Therapist
  • Whiting, NJ
National Provider Identifier
1174886105
Registry record updated Jan 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01324900 Issued in NJ
Practice address
67 Lacey Rd
Suite 8-12
Whiting, NJ 08759-2912
Phone
(732) 849-0700
NPI assigned
Jun 25, 2012
Last updated
Jan 31, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2014

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 40QA01324900 NJ Primary

Addresses

Primary practice location

67 Lacey Rd
Suite 8-12
Whiting, NJ 08759-2912

Mailing address

67 Lacey Rd
Suite 8-12
Whiting, NJ 08759-2912

Other names 1

  • Jennifer Bohn Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120725000350 NJ Practitioner - Physical Therapist in Private Practice 2961668686 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2006
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)

300 Princeton Hightstown Rd
Suite 201
East Windsor, NJ 08520-1411
Phone (609) 426-4442

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ivyrehab Network Inc. Physical Therapist Current Accepting new patients
Ivyrehab Network, Inc. Physical Therapist CurrentSince Mar 3, 2020 Accepting new patients
Ivyrehab Network Inc Physical Therapist CurrentSince Mar 3, 2020 Accepting new patients

Locations

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

67 Lacey Rd
Ste 812
Whiting, NJ 08759
Phone (732) 849-0080

1377 Motor Pkwy
Ste 307
Ronkonkoma, NY 11749

Organizations & group practices 3

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": "1340582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391126400000",
    "number": "1174886105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 LACEY RD",
            "address_2": "SUITE 8-12",
            "city": "WHITING",
            "state": "NJ",
            "postal_code": "087592912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67 LACEY RD",
            "address_2": "SUITE 8-12",
            "city": "WHITING",
            "state": "NJ",
            "postal_code": "087592912",
            "telephone_number": "732-849-0700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VADAS",
        "first_name": "JENNIFER",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-25",
        "last_updated": "2014-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01324900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "BOHN",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Whiting, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2014; 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.