Organization Active NPI

Trinity Physical Therapy and Rehab Center PC

  • Physical Therapist
  • Bayonne, NJ
National Provider Identifier
1205509965
Registry record updated Jul 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
TRINITY PHYSICAL THERAPY AND REHAB CENTER PC
Practice address
305 Bayonne Crossing Way Ste 101
Bayonne, NJ 07002-5304
Phone
(201) 778-2020
NPI assigned
Jul 28, 2021
Last updated
Jul 28, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2021

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

Authorized official

Name
Engy Keriacos
Title
Office Administrator
Phone
(201) 778-2020

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary
Geriatric Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251G0304X
Sports Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251S0007X

Addresses

Primary practice location

305 Bayonne Crossing Way Ste 101
Bayonne, NJ 07002-5304

Mailing address

305 Bayonne Crossing Way Ste 101
Bayonne, NJ 07002-5304
Phone (201) 778-2020

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211216000129 NJ Part B Supplier - Clinic/Group Practice 4880085448 Receives reassigned benefits from 3 practitioners
Practice locations: Bayonne, NJ

National Provider Directory

National Provider Directory

Locations

305 Bayonne Crossing Way
Ste 101
Bayonne, NJ 07002
Phone (201) 778-2020

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1627430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627430400000",
    "number": "1205509965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 BAYONNE CROSSING WAY STE 101",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070025304",
            "telephone_number": "201-778-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 BAYONNE CROSSING WAY STE 101",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070025304",
            "telephone_number": "201-778-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRINITY PHYSICAL THERAPY AND REHAB CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-28",
        "last_updated": "2021-07-28",
        "certification_date": "2021-07-28",
        "status": "A",
        "authorized_official_last_name": "KERIACOS",
        "authorized_official_first_name": "ENGY",
        "authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
        "authorized_official_telephone_number": "201-778-2020"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2251G0304X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Geriatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Sports",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayonne, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2021; 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.