Individual provider Active NPI

Glen Smyth, PT

  • Physical Therapist
  • Flemington, NJ
National Provider Identifier
1326258666
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA00847500 Issued in NJ
Practice address
4 Walter E Foran Blvd
Suite 203
Flemington, NJ 08822-4664
Phone
(908) 237-0000
Fax
(908) 237-0001
NPI assigned
May 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 40QA00847500 NJ Primary

Addresses

Primary practice location

4 Walter E Foran Blvd
Suite 203
Flemington, NJ 08822-4664

Mailing address

4 Walter E Foran Blvd
Suite 203
Flemington, NJ 08822-4664
Phone (908) 237-0000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120824000199 NJ Practitioner - Physical Therapist in Private Practice 0941457030 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
New York Medical College, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Procare Rehabilitation, LLCGroup PAC ID 7214998038, 69 clinicians

Practice addresses (Care Compare)

340 Route 34
Suite 210
Colts Neck, NJ 07722-2434
Phone (732) 625-0170

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Procare Rehabilitation, LLC Physical Therapist CurrentSince Mar 8, 2012 Accepting new patients

Locations

340 State Route 34
Ste 210
Colts Neck, NJ 07722
Phone (732) 625-0170

4 Walter E Foran Blvd
Flemington, NJ 08822
Phone 9082370000 ext. 90823

4 Walter E Foran Blvd
Ste 203
Flemington, NJ 08822
Phone (732) 340-1012

Organizations & group practices 1

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": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1326258666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 WALTER E FORAN BLVD",
            "address_2": "SUITE 203",
            "city": "FLEMINGTON",
            "state": "NJ",
            "postal_code": "088224664",
            "telephone_number": "908-237-0000",
            "fax_number": "908-237-0001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 WALTER E FORAN BLVD",
            "address_2": "SUITE 203",
            "city": "FLEMINGTON",
            "state": "NJ",
            "postal_code": "088224664",
            "telephone_number": "908-237-0000",
            "fax_number": "908-237-0001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMYTH",
        "first_name": "GLEN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA00847500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flemington, NJ

Sources for this page

  • 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.