Individual provider Active NPI

Eric Robert Bresemann, PT

  • Physical Therapist
  • Hackensack, NJ
National Provider Identifier
1205959855
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA00706400 Issued in NJ
Practice address
25 Prospect Ave
Hackensack, NJ 07601-1960
Phone
(201) 342-1404
NPI assigned
Apr 9, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 40QA00706400 NJ Primary

Addresses

Primary practice location

25 Prospect Ave
Hackensack, NJ 07601-1960

Mailing address

4 Cherbourg Rd
Parsippany, NJ 07054-4008
Phone (973) 715-8338

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160613000585 NJ Practitioner - Physical Therapist in Private Practice 2466742911 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Physical Medicine Center of Fairview, LLCGroup PAC ID 0042706731, 6 clinicians

Practice addresses (Care Compare)

222 Bergen Blvd
Suite 8
Fairview, NJ 07022-1300
Phone (201) 945-1156

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Excellent Homecare of NJ LLC Physical Therapist CurrentSince Mar 20, 2023 Accepting new patients
Advanced Physical Medicine Center of Fairview, LLC Physical Therapist CurrentSince Jan 1, 2026 Accepting new patients

Locations

222 Bergen Blvd
Ste 8
Fairview, NJ 07022
Phone (201) 945-1156

40 Galesi Dr
Ste 5B
Wayne, NJ 07470
Phone (973) 837-8722

Organizations & group practices 2

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": "1176076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205959855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 CHERBOURG RD",
            "city": "PARSIPPANY",
            "state": "NJ",
            "postal_code": "070544008",
            "telephone_number": "973-715-8338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 PROSPECT AVE",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011960",
            "telephone_number": "201-342-1404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRESEMANN",
        "first_name": "ERIC",
        "middle_name": "ROBERT",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA00706400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hackensack, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.