Jennifer Matos, MPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA01071500 Issued in NJ

Practice address

90 Bergen St
Ste 330
Newark, NJ 07103-2425

Phone

(908) 370-4297

NPI assigned

Apr 17, 2007

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

• Ms. Jennifer Reverendo Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1295951598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "336 MARTIN RD",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070837948",
            "telephone_number": "908-370-4297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 BERGEN ST",
            "address_2": "STE 330",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032425",
            "telephone_number": "908-370-4297"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Route 57",
            "address_2": "Suite 1",
            "address_purpose": "LOCATION",
            "city": "Phillipsburg",
            "state": "NJ",
            "postal_code": "08865",
            "country_code": "US",
            "telephone_number": "908-387-1277",
            "fax_number": "908-387-1280",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATOS",
        "first_name": "JENNIFER",
        "name_prefix": "Ms.",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-17",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01071500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "REVERENDO",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Odette Nsinga Mathos, APN
• Brianna Matias, MD
• John Richard Matjucha, MD
• Dally Matos-Mercado
• Annamarie Matos, NP-C
• Patrick Mattern, MD
• Ryann Leigh Mattessich, ACNP
• Monica Rene' Matthews, MS, ATC
• Maryna Matys, NP
• Corazon C Maurrasse, MD

• Physical Therapist in Newark, NJ
• Providers in Newark, 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 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.