Kim R Minervini, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA00792200 Issued in NJ

Practice address

104 Chestnut St
Ridgewood, NJ 07450-2502

Phone

(201) 493-8111

Fax

(201) 493-8279

NPI assigned

Dec 8, 2006

Last updated

Aug 29, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Kim R Soscia Former name

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1998

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

State licenses

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
• Cornerstone Chiropractic & Rehabilitation Center, LLC

  • Chiropractor
  • Riverdale, NJ
  • NPI 1508065236

  Physical Therapist

  Medicare reassignment NPD
• All-Pro Health

  • Sports Physical Therapist
  • Livingston, NJ
  • NPI 1215466099
  NPD (past)
• Cornerstone Medical Procedures LLC

  • Medical Specialty Clinic/Center
  • Riverdale, NJ
  • NPI 1205509460
  NPD (past)
• Mega Medical Group

  • Specialist
  • Clifton, NJ
  • NPI 1669591590
  NPD (past)
• Schragen Chiropractic

  • Chiropractor
  • Livingston, NJ
  • NPI 1821349911

  Physical Therapist

  NPD (past)
• Twin Boro Physical Therapy Associates PA

  dba Twin Boro Physical Therapy

  • Physical Therapist
  • Clark, NJ
  • NPI 1811937527
  NPD (past)
• Twin Boro Physical Therapy Associates, PA

  dba Twin Boro Physical Therapy

  • Occupational Therapist
  • Newark, NJ
  • NPI 1659874857
  NPD (past)

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377734400000",
    "number": "1275692824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 BEARFORT RD",
            "city": "WEST MILFORD",
            "state": "NJ",
            "postal_code": "074801401",
            "telephone_number": "973-903-3346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 CHESTNUT ST",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074502502",
            "telephone_number": "201-493-8111",
            "fax_number": "201-493-8279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINERVINI",
        "first_name": "KIM",
        "middle_name": "R",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-08",
        "last_updated": "2013-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA00792200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIM",
            "last_name": "SOSCIA",
            "middle_name": "R",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Cindy Miller, LCSW
• Wayne A Miller, D.C.
• Mindfully Mine Counseling Center
• Bruce P Mindich, M.D.
• Robert Dwight Miner, DDS, ROBERT D. MINER, DDS
• Ibrahim I Mirkhan, DMD
• Malaka Abdellatif Mohamed
• Islam Moheisen, DMD
• Christine Mohle, LCSW
• Nicole Mohr, PT

• Physical Therapist in Ridgewood, NJ
• Providers in Ridgewood, 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 29, 2013; 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.