Eric R Theriault, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA01695000 Issued in NJ

Practice address

3121 Fire Rd Ste D
Egg Harbor Township, NJ 08234-9619

Phone

(609) 377-8881

Fax

(732) 855-9755

NPI assigned

Aug 11, 2016

Sex

Male

Sole proprietor

No

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, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Twin Boro Physical Therapy Associates, PAGroup PAC ID 8527962950, 89 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.

• Twin Boro Physical Therapy Associates PA

  • Physical Therapist
  • Clark, NJ
  • NPI 1811937527
  Medicare reassignment Care Compare group NPD
• Twin Boro Physical Therapy Associates, PA

  • Occupational Therapist
  • Newark, NJ
  • NPI 1659874857
  NPD

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

{
    "created_epoch": "1470873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583107200000",
    "number": "1295289957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1014",
            "city": "CLARK",
            "state": "NJ",
            "postal_code": "070661014",
            "telephone_number": "732-855-9751",
            "fax_number": "732-855-9755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3121 FIRE RD STE D",
            "city": "EGG HARBOR TOWNSHIP",
            "state": "NJ",
            "postal_code": "082349619",
            "telephone_number": "609-377-8881",
            "fax_number": "732-855-9755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THERIAULT",
        "first_name": "ERIC",
        "middle_name": "R",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-11",
        "last_updated": "2020-03-02",
        "certification_date": "2020-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01695000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Arc of Atlantic County, Inc.
• The Crossroads ABA Center, LLC
• The Devereux Foundation
• The Devereux Foundation
• The Nemours Foundation
• Lisa Irene Thomas El, LCADC
• Shayna Thomas, LPN
• Sultana Thomas
• Anjail Hanyyah Thompson
• Katie Thompson

• Physical Therapist in Egg Harbor Township, NJ
• Providers in Egg Harbor Township, 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 Mar 2, 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.