Jessica Leigh Grimm, DPT

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

40QA01509700 Issued in NJ

Practice address

104 Chestnut St
Ridgewood, NJ 07450-2502

Phone

(201) 493-8111

NPI assigned

Sep 12, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ridgewood Physical Therapy and Rehabilitation Center IncGroup PAC ID 1850349820, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Ridgewood Physical Therapy and Rehabilitation Center Inc.

  • Physical Therapy Clinic/Center
  • Ridgewood, NJ
  • NPI 1548340052
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1378944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523836800000",
    "number": "1356776991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "551 HOLLY CT",
            "city": "MAHWAH",
            "state": "NJ",
            "postal_code": "074303434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 CHESTNUT ST",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074502502",
            "telephone_number": "201-493-8111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIMM",
        "first_name": "JESSICA",
        "middle_name": "LEIGH",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-12",
        "last_updated": "2018-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NJ",
            "license": "40QA01509700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Greenlee, LCSW
• Marni Leigh Greenwald, LCAT, BC
• Robert Greenwald
• Amrit Grewal, MD
• Carl T Grimm, LCSW
• Andrey Gritsman, M.D.
• Rita Grogan, MD
• Theresa Kathleen Grueter, LCSW
• Jordan Gruschow
• Lisa Marie Gudicello, M.D.

• Physical Therapy Clinic/Center in Ridgewood, NJ
• Providers in Ridgewood, NJ by specialty
• Physical Therapy Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2018; 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.