Individual provider Active NPI

Triston Stavros Glynos, PT

  • Physical Therapist
  • Scotch Plains, NJ
National Provider Identifier
1265403224
Registry record updated Feb 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA00939500 Issued in NJ
Practice address
403 Park Ave
Scotch Plains, NJ 07076-1759
Phone
(908) 322-3202
Fax
(908) 322-3252
NPI assigned
Jan 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2020

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 40QA00939500 NJ Primary

Addresses

Primary practice location

403 Park Ave
Scotch Plains, NJ 07076-1759

Mailing address

373 Park Ave
Scotch Plains, NJ 07076-1152
Phone (908) 322-3202

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050325000062 NJ Practitioner - Physical Therapist in Private Practice 9537115225 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Joint Motion, L.L.CGroup PAC ID 6709989585, 4 clinicians

Practice addresses (Care Compare)

373 Park Ave
Scotch Plains, NJ 07076-1152
Phone (908) 322-3202

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA00939500NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Joint Motion, L.L.C Physical Therapist CurrentSince Oct 26, 2006 Accepting new patients
Next Step Physical Therapy LLC Physical Therapist Past Accepting new patients

Locations

409B Park Ave
Scotch Plains, NJ 07076
Phone (908) 322-3202

373 Park Ave
Scotch Plains, NJ 07076
Phone (908) 322-3202

Organizations & group practices 2

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": "1138492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582848000000",
    "number": "1265403224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "373 PARK AVE",
            "city": "SCOTCH PLAINS",
            "state": "NJ",
            "postal_code": "070761152",
            "telephone_number": "908-322-3202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 PARK AVE",
            "city": "SCOTCH PLAINS",
            "state": "NJ",
            "postal_code": "070761759",
            "telephone_number": "908-322-3202",
            "fax_number": "908-322-3252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLYNOS",
        "first_name": "TRISTON",
        "middle_name": "STAVROS",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-29",
        "last_updated": "2020-02-28",
        "certification_date": "2020-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA00939500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scotch Plains, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2020; 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.