Casey Gartland, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA01637500 Issued in NJ

Practice address

50 Mount Prospect Ave Ste 207
Clifton, NJ 07013-1900

Phone

(201) 464-4749

Fax

(201) 464-4757

NPI assigned

Oct 12, 2015

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

• Casey Boutillier Former name

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2015

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 and National Provider Directory roles.

• 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": "1444608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703721600000",
    "number": "1275904690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 POWDERHORN DR",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074704252",
            "telephone_number": "973-464-0118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 MOUNT PROSPECT AVE STE 207",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070131900",
            "telephone_number": "201-464-4749",
            "fax_number": "201-464-4757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARTLAND",
        "first_name": "CASEY",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-12",
        "last_updated": "2023-12-28",
        "certification_date": "2023-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01637500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CASEY",
            "last_name": "BOUTILLIER",
            "credential": "PT, DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Physical Therapist in Clifton, NJ
• Providers in Clifton, 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 Dec 28, 2023; 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.