Jake Grootenboer, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA02030000 Issued in NJ

Practice address

776 N Rte 17
Paramus, NJ 07652-3117

Phone

(201) 225-9222

Fax

(201) 225-9223

NPI assigned

Sep 2, 2021

Sex

Male

Sole proprietor

Yes

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, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Professional Occupational and Physical Therapy, PLLCGroup PAC ID 3779873401, 497 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.

• Professional Occupational & Physical Therapy, PLLC

  • Occupational Therapist
  • Sicklerville, NJ
  • NPI 1215487772

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Professional Occupational & Physical Therapy, PLLC

  • Occupational Therapist
  • Randolph, NJ
  • NPI 1104376680

  Physical Therapist

  NPD
• Professional Occupational & Physical Therapy, PLLC

  • Occupational Therapist
  • Whitestone, NY
  • NPI 1487104261

  Physical Therapist

  NPD

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

{
    "created_epoch": "1630540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1275201394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 NEWMAN SPRINGS RD STE 220",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077015792",
            "telephone_number": "732-807-0877",
            "fax_number": "201-751-1680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "776 N RTE 17",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076523117",
            "telephone_number": "201-225-9222",
            "fax_number": "201-225-9223"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "650 From Rd Ste 420",
            "address_purpose": "LOCATION",
            "city": "Paramus",
            "state": "NJ",
            "postal_code": "076523551",
            "country_code": "US",
            "telephone_number": "201-639-6620",
            "fax_number": "201-972-8980",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "50 Craig Rd",
            "address_purpose": "LOCATION",
            "city": "Montvale",
            "state": "NJ",
            "postal_code": "076451709",
            "country_code": "US",
            "telephone_number": "201-639-6620",
            "fax_number": "201-972-8980",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "795 Franklin Ave Bldg A",
            "address_purpose": "LOCATION",
            "city": "Franklin Lakes",
            "state": "NJ",
            "postal_code": "074171368",
            "country_code": "US",
            "telephone_number": "201-972-8967",
            "fax_number": "201-972-8968",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GROOTENBOER",
        "first_name": "JAKE",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-09-02",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA02030000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Reshma R Grindle, REGISTERED DIETITIAN
• Lev Grinman, M.D.
• Michael Buck Groetsch, M.D.
• Lisa J. Grohsman, R.N., APN-C.
• Agnieszka Gronostajska
• Michael L Gross, MD
• Abigail M Grossman, M.D.
• Ariella Rebeccah Grossman, FNP-C
• Michael John Grounard Lacovara, DPT
• Elizabeth Rose Guardino

• Physical Therapist in Paramus, NJ
• Providers in Paramus, 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 15, 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.