Individual provider Active NPI

Cherry Ann A Mineses, PT, DPT

  • Physical Therapist
  • Clifton, NJ
National Provider Identifier
1366506719
Registry record updated Feb 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01221500 Issued in NJ
Practice address
93 Chelsea Rd
Clifton, NJ 07012
Phone
(201) 532-5911
NPI assigned
Dec 20, 2006
Last updated
Feb 2, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2016

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 40QA01221500 NJ Primary

Addresses

Primary practice location

93 Chelsea Rd
Clifton, NJ 07012

Mailing address

93 Chelsea Rd
Clifton, NJ 07012-1634
Phone (201) 532-5911

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070830000173 NJ Practitioner - Physical Therapist in Private Practice 6901999382 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ec Kinetic Physical Therapy LLCGroup PAC ID 1052695616, 3 clinicians

Practice addresses (Care Compare)

120 E Halsey Rd
Parsippany, NJ 07054-3720
Phone (973) 794-3080

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA01221500NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Diego Ruiz DC LLC Physical Therapist CurrentSince Oct 1, 2006 Accepting new patients
Ec Kinetic Physical Therapy, LLC Physical Therapist CurrentSince May 18, 2016 Accepting new patients
Ec Kintetic Physical Therapy LLC Current Accepting new patients

Locations

48 Horsehill Rd
Cedar Knolls, NJ 07927
Phone (412) 608-0596

582 Franklin Ave
Nutley, NJ 07110
Phone (973) 661-4601

120 E Halsey Rd
Parsippany, NJ 07054
Phone (201) 667-6971

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454371200000",
    "number": "1366506719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "93 CHELSEA RD",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070121634",
            "telephone_number": "201-532-5911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "93 CHELSEA RD",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "07012",
            "telephone_number": "201-532-5911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINESES",
        "first_name": "CHERRY ANN",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-20",
        "last_updated": "2016-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01221500",
            "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 Feb 2, 2016; 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.