Individual provider Active NPI

Camina Marilin Balmores, PT

  • Physical Therapist
  • Southampton, NJ
National Provider Identifier
1306611769
Registry record updated Nov 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA02218900 Issued in NJ
Practice address
1805 Route 206 Ste 3
Southampton, NJ 08088-3558
Phone
(609) 859-2426
NPI assigned
Nov 16, 2023
Last updated
Nov 19, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2023

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 40QA02218900 NJ Primary

Addresses

Primary practice location

1805 Route 206 Ste 3
Southampton, NJ 08088-3558

Mailing address

1 Slab Branch Rd
Medford, NJ 08055-8186

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, AZ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240227000788 NJ Practitioner - Physical Therapist in Private Practice 8224473533 Reassigns benefits to 2 organizations
I20260209002012 AZ Practitioner - Physical Therapist in Private Practice 8224473533 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

8643 W Kelton LN
Suite 106
Peoria, AZ 85382-3505
Phone (623) 979-8900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA02218900NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rehabclinics SPT Inc CurrentSince Jan 22, 2024 Accepting new patients
Spooner Physical Therapy and Hand Rehab, PC Physical Therapist CurrentSince Jan 5, 2026 Accepting new patients
Spooner Physical Therapy & Hand Rehab, PC CurrentSince Jan 5, 2026 Accepting new patients
Osprey Rehabilitation, LLC. CurrentSince Jan 22, 2024 Accepting new patients
Osprey Rehabilitation, LLC. CurrentSince Jan 22, 2024 Accepting new patients
Osprey Rehabilitation, LLC. Physical Therapist Current Accepting new patients
Rehabclinics SPT Inc. Current Accepting new patients
Rehabclinics SPT, Inc. CurrentSince Jan 22, 2024 Accepting new patients

Locations

8643 W Kelton Ln
Ste 106
Peoria, AZ 85382
Phone (623) 979-8900

9097 E Desert Cove Ave
Ste 110
Scottsdale, AZ 85260
Phone (480) 860-4298

2144 US Highway 130
Ste 12
Bordentown, NJ 08505
Phone (609) 324-9320

240 S White Horse Pike
Ste C6
Hammonton, NJ 08037
Phone (609) 561-5308

127 Bridgeton Pike
Unit D
Mullica Hill, NJ 08062
Phone (856) 478-0275

1805 Route 206
Ste 3
Southampton, NJ 08088
Phone (609) 859-2426

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1700092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700352000000",
    "number": "1306611769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SLAB BRANCH RD",
            "city": "MEDFORD",
            "state": "NJ",
            "postal_code": "080558186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 ROUTE 206 STE 3",
            "city": "SOUTHAMPTON",
            "state": "NJ",
            "postal_code": "080883558",
            "telephone_number": "609-859-2426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALMORES",
        "first_name": "CAMINA",
        "middle_name": "MARILIN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-16",
        "last_updated": "2023-11-19",
        "certification_date": "2023-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA02218900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southampton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 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.