Individual provider Active NPI

Imani Coleman, PT, DPT

  • Physical Therapist
  • Livingston, NJ
National Provider Identifier
1356018337
Registry record updated Aug 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA02038500 Issued in NJ
Practice address
555 S Livingston Ave
Livingston, NJ 07039-5410
Phone
(973) 974-9292
NPI assigned
Aug 26, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2021

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 40QA02038500 NJ Primary

Addresses

Primary practice location

555 S Livingston Ave
Livingston, NJ 07039-5410

Mailing address

605 Main St
Hackensack, NJ 07601-5914
Phone (201) 488-0488

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210929001126 NJ Practitioner - Physical Therapist in Private Practice 6608273958 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vitality Health CareGroup PAC ID 2567807829, 4 clinicians
Jag-One Physical Therapy LLCGroup PAC ID 2769584325, 334 clinicians

Practice addresses (Care Compare)

16 Orange St
Bloomfield, NJ 07003-4726
Phone (908) 432-1752

2360 Morris Ave
Union, NJ 07083-5707
Phone (908) 206-1700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA02038500NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Jag-One Physical Therapy, LLC Physical Therapist CurrentSince Jun 6, 2022 Accepting new patients
Vitality Health Care Physical Therapist CurrentSince Mar 12, 2025 Accepting new patients

Locations

16 Orange St
Bloomfield, NJ 07003
Phone (908) 432-1752

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

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

884 Commons Way
Bldg H
Toms River, NJ 08755
Phone (732) 244-7004

2360 Morris Ave
Union, NJ 07083
Phone (908) 206-1700

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

Organizations & group practices 2

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": "1629936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629936000000",
    "number": "1356018337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 MAIN ST",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076015914",
            "telephone_number": "201-488-0488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 S LIVINGSTON AVE",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070395410",
            "telephone_number": "973-974-9292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "IMANI",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-26",
        "last_updated": "2021-08-26",
        "certification_date": "2021-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA02038500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livingston, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2021; 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.