Jason James Supernavage, MSPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA01075700 Issued in NJ

Practice address

291 Harding Hwy
Suite a
Carneys Point, NJ 08069-2229

Phone

(856) 299-9229

Fax

(856) 299-9226

NPI assigned

Jan 25, 2007

Sex

Male

Sole proprietor

Yes

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, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Boston Associates Rehabilitation LLCGroup PAC ID 7618073016, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Boston Associates Rehabilitation LLC

  • Rehabilitation Clinic/Center
  • Carneys Point, NJ
  • NPI 1912037482
  Medicare reassignment Care Compare group Authorized official
• Bar Physical Therapy

  • Physical Therapist
  • Pennsville, NJ
  • NPI 1437980729
  NPD Authorized official

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306992367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 MARYLAND AVE",
            "city": "PENNSVILLE",
            "state": "NJ",
            "postal_code": "080701528",
            "telephone_number": "856-678-8078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "291 HARDING HWY",
            "address_2": "SUITE A",
            "city": "CARNEYS POINT",
            "state": "NJ",
            "postal_code": "080692229",
            "telephone_number": "856-299-9229",
            "fax_number": "856-299-9226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUPERNAVAGE",
        "first_name": "JASON",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "MSPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01075700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brenda L. Smith, APN
• Southgate Health Care Center,Inc
• Anthony Joseph Spano, PSY.D.
• Lisa Michelle Starner
• Sasha Strain
• Laura Jean Taylor, LPC, LPCMH
• The Arc of Salem County
• Katelyn Renee Thomas, MS, RDN, CDE
• Imajae Monique Tomlinson
• Jose Alberto Torres-Ramirez, LMFT

• Physical Therapist in Carneys Point, NJ
• Providers in Carneys Point, 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 Jul 8, 2007; 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.