Organization Active NPI

Personalized Physical Therapy, Inc

  • Physical Therapist
  • Toms River, NJ
National Provider Identifier
1407954563
Registry record updated Mar 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA00771300 Issued in NJ
Legal business name
PERSONALIZED PHYSICAL THERAPY, INC
Practice address
325 W Water Street
Suite 1
Toms River, NJ 08753
Phone
(732) 349-4170
Fax
(732) 349-6758
NPI assigned
Sep 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2013

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

Authorized official

Name
Ms. Jessica Mineo
Title
Administrator
Phone
(732) 349-4170

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X 40QA00771300 NJ Primary

Addresses

Primary practice location

325 W Water Street
Suite 1
Toms River, NJ 08753

Mailing address

325 W Water Street
Suite 1
Toms River, NJ 08753
Phone (732) 349-4170

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040928000429 NJ Part B Supplier - Physical/Occupational Therapy Group in Private Practice 4486631405 Receives reassigned benefits from 1 practitioner
Practice locations: Toms River, NJ

National Provider Directory

National Provider Directory

Locations

325 W Water St
Fl 1
Toms River, NJ 08753
Phone (732) 349-4170

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": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363651200000",
    "number": "1407954563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 W WATER STREET",
            "address_2": "SUITE 1",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "08753",
            "telephone_number": "732-349-4170",
            "fax_number": "732-349-6758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 W WATER STREET",
            "address_2": "SUITE 1",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "08753",
            "telephone_number": "732-349-4170",
            "fax_number": "732-349-6758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERSONALIZED PHYSICAL THERAPY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2013-03-19",
        "status": "A",
        "authorized_official_last_name": "MINEO",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "732-349-4170",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA00771300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toms River, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2013; 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.