Alexander Jordan Pena, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA02260100 Issued in NJ

Practice address

107 Rowan Blvd
Glassboro, NJ 08028-2203

Phone

(856) 347-0333

NPI assigned

Jul 1, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Trifecta Therapeutics LLCGroup PAC ID 4789942483, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Trifecta Therapeutics, LLC

  • Sports Physical Therapist
  • Glassboro, NJ
  • NPI 1841701141
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1719792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1235975194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 OSWEGO CT",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080545277",
            "telephone_number": "609-781-1556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 ROWAN BLVD",
            "city": "GLASSBORO",
            "state": "NJ",
            "postal_code": "080282203",
            "telephone_number": "856-347-0333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENA",
        "first_name": "ALEXANDER",
        "middle_name": "JORDAN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-01",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA02260100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pinal Patel, PA-C
• Ryan Vipulkumar Patel
• Vibhutiben Amitbhai Patel, PT
• Stefani Lauren Pelly, LSW
• John E Pelosi, DPM
• Melissa Pine
• Lauren Jessica Pino, PHARMD
• Danielle Player
• Helen E Polak, PSY.D.
• Pomegranate Wellness Health Aesthetics

• Physical Therapist in Glassboro, NJ
• Providers in Glassboro, 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 Jul 1, 2024; 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.