Individual provider Active NPI

Renata Tatgenhorst, DPT

  • Physical Therapist
  • Old Bridge, NJ
National Provider Identifier
1356698849
Registry record updated Jul 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01456200 Issued in NJ
Practice address
254 Texas Rd
Old Bridge, NJ 08857-4008
Phone
(732) 561-3401
NPI assigned
Aug 14, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 048742 NY
Physical Therapist 225100000X 40QA01456200 NJ Primary

Addresses

Primary practice location

254 Texas Rd
Old Bridge, NJ 08857-4008

Mailing address

981 US Highway 22 FL 2
Bridgewater, NJ 08807-2946
Phone (201) 801-7141

Other names 1

  • Renata Pac Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120906000772 NJ Practitioner - Physical Therapist in Private Practice 3779731278 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
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)

1121 State Route 34
Suite 14
Aberdeen, NJ 07747-2161
Phone (732) 377-3557

176 US Hwy 9
Suite 204
Englishtown, NJ 07726-9220
Phone (732) 374-9523

221 Rockingham Row
Princeton, NJ 08540-5759
Phone (609) 580-1520

254 Texas Rd
Old Bridge, NJ 08857-4008
Phone (732) 561-3401

345 Union Hill Rd
Manalapan, NJ 07726-1875
Phone (732) 972-5565

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
40QA01456200NJMDPhysical Therapist
048742NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Jag-One Physical Therapy, LLC Physical Therapist CurrentSince Jul 31, 2012 Accepting new patients

Locations

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

254 Texas Rd
Old Bridge, NJ 08857
Phone (732) 359-2691

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

34 Mountain Blvd
Ste C
Warren, NJ 07059
Phone (908) 222-0515

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

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": "1344902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658275200000",
    "number": "1356698849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "981 US HIGHWAY 22 FL 2",
            "city": "BRIDGEWATER",
            "state": "NJ",
            "postal_code": "088072946",
            "telephone_number": "201-801-7141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "254 TEXAS RD",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "088574008",
            "telephone_number": "732-561-3401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATGENHORST",
        "first_name": "RENATA",
        "name_prefix": "Ms.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-14",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "048742",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01456200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RENATA",
            "last_name": "PAC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Old Bridge, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 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.