Individual provider Active NPI

Irina Fookson, DPT

  • Physical Therapist
  • Holmdel, NJ
National Provider Identifier
1235176652
Registry record updated Apr 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01047600 Issued in NJ
Practice address
723 N Beers St Ste 2E
Holmdel, NJ 07733-1512
Phone
(732) 525-0123
NPI assigned
Jun 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2023

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 40QA01047600 NJ Primary

Addresses

Primary practice location

723 N Beers St Ste 2E
Holmdel, NJ 07733-1512

Mailing address

723 N Beers St Ste 2E
Holmdel, NJ 07733-1512

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210503000957 NJ Practitioner - Physical Therapist in Private Practice 8729038237 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

723 N Beers St
Suite 2E
Holmdel, NJ 07733-1512
Phone (732) 766-8300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA01047600NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Therapy Doctor NJ, PC Physical Therapist CurrentSince Apr 7, 2021 Accepting new patients
Kessler Institute for Rehabilitation, Inc. Past Accepting new patients
Complete Rehab Therapy, P.C Physical Therapist PastSince Oct 12, 2004 Accepting new patients

Locations

719 N Beers St
Ste 2B
Holmdel, NJ 07733
Phone (732) 344-2192

723 N Beers St
Ste 2E
Holmdel, NJ 07733
Phone (732) 264-3344

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/25401/brand/1/csg/1/fhir/r4

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682121600000",
    "number": "1235176652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "723 N BEERS ST STE 2E",
            "city": "HOLMDEL",
            "state": "NJ",
            "postal_code": "077331512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "723 N BEERS ST STE 2E",
            "city": "HOLMDEL",
            "state": "NJ",
            "postal_code": "077331512",
            "telephone_number": "732-525-0123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOOKSON",
        "first_name": "IRINA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-02",
        "last_updated": "2023-04-22",
        "certification_date": "2023-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01047600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holmdel, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2023; 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.