Individual provider Active NPI

Karina Jimenez, RPT

  • Physical Therapist
  • Hackensack, NJ
National Provider Identifier
1306198635
Registry record updated Oct 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01407600 Issued in NJ
Practice address
28-32 Van Orden PL
Hackensack, NJ 07601-6011
Phone
(201) 621-0300
NPI assigned
Oct 10, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 40QA01407600 NJ Primary

Addresses

Primary practice location

28-32 Van Orden PL
Hackensack, NJ 07601-6011

Mailing address

617 82ND St
North Bergen, NJ 07047-6514
Phone (201) 313-0977

Other identifiers 1

IdentifierTypeStateIssuer
40QA1407600OtherNJLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121227000137 NJ Practitioner - Physical Therapist in Private Practice 1355594300 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sportscare of America, PCGroup PAC ID 9032213756, 132 clinicians

Practice addresses (Care Compare)

6612 Bergenline Ave
West New York, NJ 07093-1719
Phone (201) 854-5511

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA01407600NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
United Sports Care & Physical Therapy Physical Therapist CurrentSince Aug 1, 2016 Accepting new patients
Alliance Hand and Physical Therapy, P.C. CurrentSince Jun 24, 2013 Accepting new patients
Alliance Hand and Physical Therapy, P.C. Physical Therapist CurrentSince Jun 24, 2013 Accepting new patients
Sportscare of America, PC Physical Therapist CurrentSince Aug 1, 2016 Accepting new patients

Locations

47 S Washington Ave
Bergenfield, NJ 07621
Phone (201) 384-2525

197 Ridgedale Ave
Cedar Knolls, NJ 07927
Phone (973) 292-0700

11 Eagle Rock Ave
Ste 201
East Hanover, NJ 07936
Phone (973) 887-0115

28-32 Van Orden Pl
Hackensack, NJ 07601
Phone (201) 621-0300

6612 Bergenline Ave
#18
West New York, NJ 07093
Phone (201) 845-5511

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1349827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382313600000",
    "number": "1306198635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "617 82ND ST",
            "city": "NORTH BERGEN",
            "state": "NJ",
            "postal_code": "070476514",
            "telephone_number": "201-313-0977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28-32 VAN ORDEN PL",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076016011",
            "telephone_number": "201-621-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "KARINA",
        "credential": "RPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-10",
        "last_updated": "2013-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01407600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "40QA1407600",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hackensack, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 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.