Individual provider Active NPI

Katharina Metrokotsas, PT, DPT

  • Physical Therapist
  • Woodbridge, NJ
National Provider Identifier
1326566886
Registry record updated Sep 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01741000 Issued in NJ
Practice address
10 Woodbridge Center Dr Ste 102
Woodbridge, NJ 07095-1153
Phone
(732) 855-0380
NPI assigned
Sep 5, 2017
Last updated
Sep 5, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2017

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 40QA01741000 NJ Primary

Addresses

Primary practice location

10 Woodbridge Center Dr Ste 102
Woodbridge, NJ 07095-1153

Mailing address

10 Woodbridge Center Dr Ste 102
Woodbridge, NJ 07095-1153
Phone (732) 855-0380

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171018003063 NJ Practitioner - Physical Therapist in Private Practice 3072889070 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jag-One Physical Therapy LLCGroup PAC ID 2769584325, 334 clinicians

Practice addresses (Care Compare)

622 Eagle Rock Ave
West Orange, NJ 07052-2994
Phone (973) 669-0078

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA01741000NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Jag-One Physical Therapy, LLC Physical Therapist CurrentSince Apr 21, 2018 Accepting new patients

Locations

981 US Highway 22
Fl 2
Bridgewater, NJ 08807
Phone (908) 231-0511

221 Rockingham Row
Princeton, NJ 08540
Phone (609) 580-1520

622 Eagle Rock Ave
West Orange, NJ 07052
Phone (973) 669-0078

10 Woodbridge Center Dr
Ste 102
Woodbridge, NJ 07095
Phone (732) 588-6935

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, 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": "1504569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504569600000",
    "number": "1326566886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 WOODBRIDGE CENTER DR STE 102",
            "city": "WOODBRIDGE",
            "state": "NJ",
            "postal_code": "070951153",
            "telephone_number": "732-855-0380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 WOODBRIDGE CENTER DR STE 102",
            "city": "WOODBRIDGE",
            "state": "NJ",
            "postal_code": "070951153",
            "telephone_number": "732-855-0380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "METROKOTSAS",
        "first_name": "KATHARINA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-05",
        "last_updated": "2017-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01741000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2017; 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.