Individual provider Active NPI

Anthony Benjamin

  • Physical Therapist
  • Marlboro, NJ
National Provider Identifier
1366097313
Registry record updated Aug 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01871000 Issued in NJ
Practice address
17 N Main St
Marlboro, NJ 07746-2063
Phone
(732) 431-2155
NPI assigned
Aug 6, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2019

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 40QA01871000 NJ Primary

Addresses

Primary practice location

17 N Main St
Marlboro, NJ 07746-2063

Mailing address

133 Wyncrest Rd
Marlboro, NJ 07746-1695
Phone (917) 674-0149

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191025002034 NJ Practitioner - Physical Therapist in Private Practice 9638401540 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prestige Rehab LLCGroup PAC ID 3375936495, 59 clinicians

Practice addresses (Care Compare)

20 Country Club LN
Colts Neck, NJ 07722-2222
Phone (855) 678-8887

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA01871000NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Outreach Physical and Occupational Therapy & Speech Rehabilitation, PLLC Physical Therapist CurrentSince Dec 8, 2022 Accepting new patients
East Brunswick Physical Therapy Physical Therapist CurrentSince Mar 9, 2022 Accepting new patients
Advanced Wellness Physical Therapist CurrentSince Sep 9, 2019 Accepting new patients
Prestige Rehab LLC Physical Therapist CurrentSince Jul 21, 2022 Accepting new patients
Schick Chiropractic Center, LLC Physical Therapist CurrentSince Feb 15, 2021 Accepting new patients

Locations

3 Auer Ct
Ste D
East Brunswick, NJ 08816
Phone (732) 254-2273

317 Cleveland Ave
Highland Park, NJ 08904
Phone (732) 249-9800

17 N Main St
Marlboro, NJ 07746
Phone (732) 431-2155

3 Grace Ave
Ste 119
Great Neck, NY 11021
Phone (212) 842-0080

1110 2nd Ave
Rm 302
New York, NY 10022
Phone (212) 842-0080

Organizations & group practices 5

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": "1565049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565049600000",
    "number": "1366097313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 WYNCREST RD",
            "city": "MARLBORO",
            "state": "NJ",
            "postal_code": "077461695",
            "telephone_number": "917-674-0149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 N MAIN ST",
            "city": "MARLBORO",
            "state": "NJ",
            "postal_code": "077462063",
            "telephone_number": "732-431-2155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENJAMIN",
        "first_name": "ANTHONY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-06",
        "last_updated": "2019-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01871000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marlboro, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2019; 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.