Individual provider Active NPI

Kathy Lea Tate, DPT

  • Physical Therapist
  • Maywood, NJ
National Provider Identifier
1376821926
Registry record updated May 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01502000 Issued in NJ
Practice address
141 W Pleasant Ave
Maywood, NJ 07607-1333
Phone
(201) 843-0026
Fax
(201) 843-0032
NPI assigned
Aug 1, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 0033872-1 NY
Physical Therapist 225100000X 40QA01502000 NJ Primary

Addresses

Primary practice location

141 W Pleasant Ave
Maywood, NJ 07607-1333

Mailing address

8 Craven Rd
Mountain Lakes, NJ 07046-1424
Phone (201) 344-8811

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230504002019 UT Practitioner - Physical Therapist in Private Practice 1759518244 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
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

1739 W Sunset Blvd
St George, UT 84770-7141
Phone (435) 634-6080

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0033872-1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc Physical Therapist CurrentSince Sep 9, 2024 Accepting new patients
Motion Ut, LLC CurrentSince Aug 1, 2023 Accepting new patients
Ihc Health Services, Inc. CurrentSince Sep 9, 2024 Accepting new patients
Madison PT of New Jersey, PC Physical Therapist PastSince Jan 1, 2015 Accepting new patients
Madison Spine and Physicaltherapy, Inc. Physical Therapist Past Accepting new patients

Locations

4554 Forestdale Dr
Unit C16
Park City, UT 84098
Phone (435) 494-1336

5171 S Cottonwood St
Ste 900
Salt Lake City, UT 84107
Phone (801) 507-2050

1739 W Sunset Blvd
St George, UT 84770
Phone (435) 634-6000

652 S Medical Center Dr
Ste LL10
St George, UT 84790
Phone (435) 251-2250

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": "1312156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527206400000",
    "number": "1376821926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 CRAVEN RD",
            "city": "MOUNTAIN LAKES",
            "state": "NJ",
            "postal_code": "070461424",
            "telephone_number": "201-344-8811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 W PLEASANT AVE",
            "city": "MAYWOOD",
            "state": "NJ",
            "postal_code": "076071333",
            "telephone_number": "201-843-0026",
            "fax_number": "201-843-0032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATE",
        "first_name": "KATHY",
        "middle_name": "LEA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-01",
        "last_updated": "2018-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "0033872-1",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01502000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maywood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 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.