Organization Active NPI

Kerocare LLC

  • Physical Therapist
  • Clifton, NJ
National Provider Identifier
1356939326
Registry record updated Jun 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
KEROCARE LLC
Practice address
106 Pebble Brook Dr
Clifton, NJ 07014-1740
Phone
(732) 763-7114
NPI assigned
Jan 6, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2025

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

Authorized official

Name
Dr. Mina Azer, DPTNPI 1437700119
Title
Physical Therapist
Phone
(732) 763-7114

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

106 Pebble Brook Dr
Clifton, NJ 07014-1740

Mailing address

106 Pebble Brook Dr
Clifton, NJ 07014-1740
Phone (732) 763-7114

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250716000085 NJ Part B Supplier - Physical/Occupational Therapy Group in Private Practice 5698280915 Receives reassigned benefits from 1 practitioner
Practice locations: Clifton, NJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1609891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750377600000",
    "number": "1356939326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 PEBBLE BROOK DR",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070141740",
            "telephone_number": "732-763-7114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 PEBBLE BROOK DR",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070141740",
            "telephone_number": "732-763-7114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEROCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-06",
        "last_updated": "2025-06-20",
        "certification_date": "2025-06-20",
        "status": "A",
        "authorized_official_last_name": "AZER",
        "authorized_official_first_name": "MINA",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "732-763-7114",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2025; 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.