Individual provider Active NPI

Gerald Joseph Struble III, PT, DPT

  • Physical Therapist
  • Riverdale, NJ
National Provider Identifier
1205428737
Registry record updated Feb 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01991900 Issued in NJ
Practice address
69 Newark Pompton Tpke
Riverdale, NJ 07457-1426
Phone
(973) 248-8111
NPI assigned
Feb 5, 2021
Last updated
Feb 5, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2021

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 40QA01991900 NJ Primary

Addresses

Primary practice location

69 Newark Pompton Tpke
Riverdale, NJ 07457-1426

Mailing address

69 Newark Pompton Tpke
Riverdale, NJ 07457-1426
Phone (973) 248-8111

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210407000470 NJ Practitioner - Physical Therapist in Private Practice 0042627143 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Montville Physical Therapy, PCGroup PAC ID 0244398030, 14 clinicians
Wayne Orthopedic Physical Therapy, PCGroup PAC ID 5092850735, 9 clinicians
The New Jersey Center of Physical Therapy, PCGroup PAC ID 0042205023, 19 clinicians

Practice addresses (Care Compare)

2 Changebridge Rd
F
Montville, NJ 07045-8947
Phone (973) 917-3134

450 Hamburg Tpke
Wayne, NJ 07470-8480
Phone (973) 706-7620

69 Newark Pompton Tpke
Riverdale, NJ 07457-1426
Phone (973) 248-8111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The New Jersey Center of Physical Therapy, PC Physical Therapist CurrentSince Mar 1, 2021 Accepting new patients
Wayne Orthopedic Physical Therapy, PC Physical Therapist CurrentSince Jun 10, 2021 Accepting new patients
Paramus Orthopedic Physical Therapy, PC Physical Therapist CurrentSince Oct 8, 2021 Accepting new patients
Montville Physical Therapy, PC CurrentSince Oct 8, 2021 Accepting new patients
Paramus Orthopedic Physical Therapy PastSince Oct 8, 2021 Accepting new patients
Wayne Foot and Ankle Center,PA PastSince Jun 10, 2021 Accepting new patients

Locations

2 Changebridge Rd
#F
Montville, NJ 07045
Phone (973) 917-3134

2 Changebridge Rd
Ste F
Montville, NJ 07045
Phone (973) 917-3134

28 Farview Ter
Paramus, NJ 07652
Phone (201) 880-9810

69 Newark Pompton Tpke
Riverdale, NJ 07457
Phone (973) 248-8111

450 Hamburg Tpke
Wayne, NJ 07470
Phone (973) 706-7620

Organizations & group practices 6

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": "1612483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612483200000",
    "number": "1205428737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "69 NEWARK POMPTON TPKE",
            "city": "RIVERDALE",
            "state": "NJ",
            "postal_code": "074571426",
            "telephone_number": "973-248-8111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69 NEWARK POMPTON TPKE",
            "city": "RIVERDALE",
            "state": "NJ",
            "postal_code": "074571426",
            "telephone_number": "973-248-8111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STRUBLE",
        "first_name": "GERALD",
        "middle_name": "JOSEPH",
        "name_suffix": "III",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-02-05",
        "last_updated": "2021-02-05",
        "certification_date": "2021-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01991900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverdale, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2021; 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.