Individual provider Active NPI

Jennifer Virga, PT, DPT

  • Physical Therapist
  • Port Jefferson, NY
National Provider Identifier
1366821514
Registry record updated May 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01549700 Issued in NJ
Practice address
125 Oakland Ave Ste 301
Port Jefferson, NY 11777-2130
Phone
(631) 476-2737
NPI assigned
May 20, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 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 40QA01549700 NJ Primary

Addresses

Primary practice location

125 Oakland Ave Ste 301
Port Jefferson, NY 11777-2130

Mailing address

68 Columbus Ave
Belleville, NJ 07109-2066
Phone (516) 639-9380

Other practice location 1

75 N Country Rd
Port Jefferson, NY 11777-2119
Phone (631) 473-1320

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
40QA01549700NJMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1432080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556668800000",
    "number": "1366821514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68 COLUMBUS AVE",
            "city": "BELLEVILLE",
            "state": "NJ",
            "postal_code": "071092066",
            "telephone_number": "516-639-9380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 OAKLAND AVE STE 301",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117772130",
            "telephone_number": "631-476-2737"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "75 N Country Rd",
            "address_purpose": "LOCATION",
            "city": "Port Jefferson",
            "state": "NY",
            "postal_code": "117772119",
            "country_code": "US",
            "telephone_number": "631-473-1320",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VIRGA",
        "first_name": "JENNIFER",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-20",
        "last_updated": "2019-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01549700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Jefferson, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.