Brian K Brunckhorst

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT030388 Issued in PA

Practice address

1 W Ridgewood Ave
Suite 104
Paramus, NJ 07652-2359

Phone

(201) 652-1415

Fax

(201) 652-0391

NPI assigned

Sep 14, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Rehabclinics (SPT), Inc.

  • Physical Therapy Clinic/Center
  • Conshohocken, PA
  • NPI 1255330148

  Physical Therapist

  Medicare reassignment NPD
• Rehabclinics SPT, Inc.

  • Physical Therapy Clinic/Center
  • Chalfont, PA
  • NPI 1952009482
  NPD
• Sportscare Institute, Inc.

  • Physical Therapist
  • Toms River, NJ
  • NPI 1275501074
  NPD (past)

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669680000000",
    "number": "1235234972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 INVERNESS CIR",
            "city": "CHALFONT",
            "state": "PA",
            "postal_code": "189143919",
            "telephone_number": "201-456-8534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 W RIDGEWOOD AVE",
            "address_2": "SUITE 104",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076522359",
            "telephone_number": "201-652-1415",
            "fax_number": "201-652-0391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNCKHORST",
        "first_name": "BRIAN",
        "middle_name": "K",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-14",
        "last_updated": "2022-11-29",
        "certification_date": "2022-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01149200",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT030388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Althea Doreen Brown
• Diana Brown, BCBA
• Eugene Rulon Brown III, L.AC., C.A., DOM
• Skylar Brown
• Eric R. Brummer, P.T., C.H.T.
• Victoria Regina Bueschen, PA-C
• Mikaela Ivonne Bulman, MD
• Brandon Bumbaco, LSW
• Kathleen M Burckard, LMT
• Patricia A Burke, MD PHD

• Physical Therapist in Paramus, NJ
• Providers in Paramus, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2022; 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.