Kyrillos Hany Barsoum, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA02120700 Issued in NJ

Practice address

10 Woodbridge Center Dr Ste 102
Woodbridge, NJ 07095-1153

Phone

(732) 588-6935

NPI assigned

Aug 31, 2022

Last updated

Aug 31, 2022By the provider in NPPES

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, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jag-One Physical Therapy LLCGroup PAC ID 2769584325, 334 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Jag-One Physical Therapy, LLC

  • Physical Therapist
  • West Orange, NJ
  • NPI 1518017144
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1661904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661904000000",
    "number": "1245950187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "543 GARDEN PL",
            "city": "KEYPORT",
            "state": "NJ",
            "postal_code": "077355012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 WOODBRIDGE CENTER DR STE 102",
            "city": "WOODBRIDGE",
            "state": "NJ",
            "postal_code": "070951153",
            "telephone_number": "732-588-6935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARSOUM",
        "first_name": "KYRILLOS",
        "middle_name": "HANY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-31",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA02120700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Omar Q Awan, M.D.
• Osama Baig
• Sharon Baldeo
• Julio C Baquerizo, NURSE PRACTITIONER
• Steven Barandica, M.ED., ATC, LAT, EMT
• Taylor Lynn Barto, OTR/L
• Inna Basanskaya, DPT
• Jamie Basile, PHARMD
• Baver and Corduan Family Chiropractic Health Center P.C.
• Bruce Alan Baver, D.C.

• Physical Therapist in Woodbridge, NJ
• Providers in Woodbridge, 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 Aug 31, 2022; 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.