Individual provider Active NPI

Benjamin R Harris, PT, DPT

  • Physical Therapist
  • West Berlin, NJ
National Provider Identifier
1356059158
Registry record updated Nov 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA02136100 Issued in NJ
Practice address
115 NJ-73
Unit 80
West Berlin, NJ 08091
Phone
(856) 335-4938
NPI assigned
Nov 10, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2022

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 40QA02136100 NJ Primary

Addresses

Primary practice location

115 NJ-73
Unit 80
West Berlin, NJ 08091

Mailing address

175 Route 70 Ste 19
Medford, NJ 08055-2355

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20221209002076 NJ Practitioner - Physical Therapist in Private Practice 7517336704 Reassigns benefits to 1 organization
I20260112001302 PA Practitioner - Physical Therapist in Private Practice 7517336704 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ipta Clinical, LLCGroup PAC ID 0749456119, 126 clinicians

Practice addresses (Care Compare)

401 S 2ND St
Suite LL
Philadelphia, PA 19147-1612
Phone (267) 519-2552

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA02136100NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
3 Dimensional Physical Therapy - Pelvic Health LLC Physical Therapist CurrentSince Feb 23, 2025 Accepting new patients
Ipta Clinical, LLC Physical Therapist CurrentSince Nov 4, 2022 Accepting new patients

Locations

175 Route 70
Ste 19
Medford, NJ 08055
Phone (609) 257-3750

115 N Route 73
Unit 80
West Berlin, NJ 08091
Phone (856) 335-4938

261 Old York Rd
Ste 204
Jenkintown, PA 19046
Phone (267) 616-9227

401 S 2nd St
Ste Ll
Philadelphia, PA 19147
Phone (267) 519-2552

401 S 2nd St
Philadelphia, PA 19147
Phone (267) 519-2552

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": "1668038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668038400000",
    "number": "1356059158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 ROUTE 70 STE 19",
            "city": "MEDFORD",
            "state": "NJ",
            "postal_code": "080552355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 NJ-73",
            "address_2": "UNIT 80",
            "city": "WEST BERLIN",
            "state": "NJ",
            "postal_code": "08091",
            "telephone_number": "856-335-4938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "BENJAMIN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-11-10",
        "last_updated": "2022-11-10",
        "certification_date": "2022-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA02136100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Berlin, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2022; 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.