Individual provider Active NPI

Joshua Bergen, MPT

  • Physical Therapist
  • New York, NY
National Provider Identifier
1245411404
Registry record updated Nov 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
62029764 Issued in NY
Practice address
622 W 168TH Street
New York, NY 10032
Phone
(212) 932-4065
NPI assigned
Nov 16, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 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 62029764 NY Primary

Addresses

Primary practice location

622 W 168TH Street
New York, NY 10032

Mailing address

19510 67TH Ave #H
Fresh Meadows, NY 11365
Phone (917) 841-3906

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180124000111 NY Practitioner - Physical Therapist in Private Practice 2769741594 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
62029764NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
B Stern Physical Therapy P.C. Physical Therapist CurrentSince May 11, 2018 Accepting new patients
Fox Rehabilitation Physical Therapy Services LLC Physical Therapist CurrentSince Dec 1, 2019 Accepting new patients
Stern at Home Physical Therapy PC Physical Therapist CurrentSince Jun 12, 2019 Accepting new patients
Genesis Medical Health PC Past Accepting new patients

Locations

7 Carnegie Plz
Cherry Hill, NJ 08003

440 Beach 21st St
Far Rockaway, NY 11691
Phone (718) 327-5500

25 Robert Pitt Dr
Ste 109
Monsey, NY 10952
Phone (845) 625-2818

23 Robert Pitt Dr
Ste 110
Monsey, NY 10952

4 Medical Park Dr
Ste B
Pomona, NY 10970
Phone (845) 354-3131

1415 Richmond Ave
Staten Island, NY 10314
Phone (212) 475-5540

2902 Upper Tibbits Ave
Troy, NY 12180
Phone (518) 273-2040

Organizations & group practices 4

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": "1195171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195171200000",
    "number": "1245411404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19510 67TH AVE #H",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "11365",
            "telephone_number": "917-841-3906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 W 168TH STREET",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10032",
            "telephone_number": "212-932-4065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGEN",
        "first_name": "JOSHUA",
        "name_prefix": "Mr.",
        "credential": "MPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-16",
        "last_updated": "2007-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "62029764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2007; 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.