Active NPI
John Randal B Cruz, PT
- Physical Therapist
- Edison, NJ
National Provider Identifier
1255677977
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 40QA01471600
- Practice address
- 26 Koster Blvd
Apt. 8B
Edison, NJ 08837-4260 - Phone
- (732) 318-4172
- NPI assigned
- Dec 27, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 40QA01471600 | NJ | Primary |
Addresses
Primary practice location
26 Koster Blvd
Apt. 8B
Edison, NJ 08837-4260
Mailing address
26 Koster Blvd
Apt. 8B
Edison, NJ 08837-4260
Phone (732) 318-4172
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| PMK Rehab,LLC | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
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": "1356566400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1379030400000",
"number": "1255677977",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26 KOSTER BLVD",
"address_2": "APT. 8B",
"city": "EDISON",
"state": "NJ",
"postal_code": "088374260",
"telephone_number": "732-318-4172"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "26 KOSTER BLVD",
"address_2": "APT. 8B",
"city": "EDISON",
"state": "NJ",
"postal_code": "088374260",
"telephone_number": "732-318-4172"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRUZ",
"first_name": "JOHN RANDAL",
"middle_name": "B",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-12-27",
"last_updated": "2013-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NJ",
"license": "40QA01471600",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Edison, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.