NPIMap

Organization Active NPI

Trinity Rehab Somerset PA

  • Physical Therapy Clinic/Center
  • Wayne, NJ
National Provider Identifier
1336747666
Registry record updated Mar 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
TRINITY REHAB SOMERSET PA
Practice address
1172 Hamburg Tpke
Wayne, NJ 07470-5054
Phone
(732) 219-5700
Fax
(732) 334-3004
NPI assigned
Oct 9, 2020
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Tonya Gavrielides
Title
Office Manager
Phone
(732) 219-5700

Other NPIs on the same Medicare enrollment 37

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 37

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170113000019 NJ Part B Supplier - Physical/Occupational Therapy Group in Private Practice 0547540809 Receives reassigned benefits from 136 practitioners
37 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Piscataway, NJ; Morristown, NJ; Red Bank, NJ; Sewell, NJ; Short Hills, NJ; Shrewsbury, NJ; Somers Point, NJ; Somerset, NJ…

National Provider Directory

National Provider Directory
Tax ID family
Trinity Rehab Somerset PA34 organizations share this tax ID, including this one

Other organizations with this tax ID 33

Organizations that report the same tax identification number in the National Provider Directory.

View all 33

Locations

910 Hamburg Tpke
Wayne, NJ 07470

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

NPPES NPI Registry

Primary practice location

1172 Hamburg Tpke
Wayne, NJ 07470-5054

Mailing address

554 Highway 35
Red Bank, NJ 07701-5066
Phone (732) 219-5700

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
1245789064OtherNJBCBS

Other names 1

NPPES NPI Registry
  • Trinity Rehab Wayne Doing business as

Electronic endpoints 1

NPPES NPI Registry
TypeEndpointUseAffiliation
Other URL Address Other

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 23, 2021.

{
    "created_epoch": "1602201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616457600000",
    "number": "1336747666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "554 HIGHWAY 35",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077015066",
            "telephone_number": "732-219-5700",
            "fax_number": "732-334-3004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1172 HAMBURG TPKE",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074705054",
            "telephone_number": "732-219-5700",
            "fax_number": "732-334-3004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRINITY REHAB SOMERSET PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-09",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-23",
        "status": "A",
        "authorized_official_last_name": "GAVRIELIDES",
        "authorized_official_first_name": "TONYA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "732-219-5700"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1245789064",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Address",
            "affiliation": "N",
            "endpointDescription": "Address",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Address",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Address",
            "address_1": "910 Hamburg Tpke",
            "city": "Wayne",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "074703225",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Trinity Rehab Wayne",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Trinity Rehab Wayne",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wayne, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.