Gary Dennis O Beredo

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA01002900 Issued in NJ

Practice address

564 Broadway Ste 2a
Bayonne, NJ 07002-3825

Phone

(201) 339-8889

NPI assigned

May 16, 2006

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

Not listed in the public Medicare enrollment file

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.

• Sportsmed PT LLC

  • Physical Therapist
  • Glen Rock, NJ
  • NPI 1841787645
  NPD

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1326090564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "564 BROADWAY SUITE 2A",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "07002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "564 BROADWAY STE 2A",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070023825",
            "telephone_number": "201-339-8889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEREDO",
        "first_name": "GARY",
        "middle_name": "DENNIS O",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01002900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Offer Ben-Arie, PA-C
• Peter Benanti, LCSW
• Jerlyn M Benejan
• Quintina Louise Benson, MD
• Beredo Physical Therapy and Wellness, LLC
• Jennifer Beredo, PT
• Erica Ann Bermudez, OTR/L
• Timothy Calca Bernardino, MD
• Liliya Besedina, M.D.
• Michael J Bessette, MD

• Physical Therapist in Bayonne, NJ
• Providers in Bayonne, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.