NPIMap

Organization Active NPI

Park Physical Therapy Associates,Inc.

  • Physical Therapist
  • Highland Park, NJ
National Provider Identifier
1194872028
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
QA00677 Issued in NJ
Legal business name
PARK PHYSICAL THERAPY ASSOCIATES,INC.
Practice address
400 Cleveland Ave
Highland Park, NJ 08904-2704
Phone
(732) 828-0700
Fax
(732) 828-0712
NPI assigned
Jan 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Frederick B Hahn, PHYSICAL THERAPIST
Title
Vice President
Phone
(732) 821-7878

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X QA00677 NJ Primary

Addresses

Primary practice location

400 Cleveland Ave
Highland Park, NJ 08904-2704

Mailing address

400 Cleveland Ave
Highland Park, NJ 08904-2704
Phone (732) 828-0700

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040305000266 NJ Part B Supplier - Physical/Occupational Therapy Group in Private Practice 6406744127 Receives reassigned benefits from 4 practitioners
Practice locations: North Brunswick, NJ; Highland Park, NJ

National Provider Directory

National Provider Directory

Locations

400 Cleveland Ave
Highland Park, NJ 08904
Phone (732) 828-0700

1584 US Highway 130
North Brunswick, NJ 08902
Phone (732) 821-7878

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1194872028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 CLEVELAND AVE",
            "city": "HIGHLAND PARK",
            "state": "NJ",
            "postal_code": "089042704",
            "telephone_number": "732-828-0700",
            "fax_number": "732-828-0712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 CLEVELAND AVE",
            "city": "HIGHLAND PARK",
            "state": "NJ",
            "postal_code": "089042704",
            "telephone_number": "732-828-0700",
            "fax_number": "732-828-0712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK PHYSICAL THERAPY ASSOCIATES,INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HAHN",
        "authorized_official_first_name": "FREDERICK",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "732-821-7878",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHYSICAL THERAPIST"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "QA00677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Highland Park, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.