Individual provider Active NPI

Boris Katz, PT

  • Physical Therapist
  • Newark, NJ
National Provider Identifier
1427290329
Registry record updated Nov 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01356400 Issued in NJ
Practice address
56 Grafton Ave
Newark, NJ 07104-4215
Phone
(973) 732-3444
Fax
(973) 732-3445
NPI assigned
Mar 24, 2009
Last updated
Nov 21, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2011

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 021289 NY
Physical Therapist 225100000X 40QA01356400 NJ Primary

Addresses

Primary practice location

56 Grafton Ave
Newark, NJ 07104-4215

Mailing address

827 Raritan Rd
Scotch Plains, NJ 07076-2719
Phone (917) 658-8284

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101007001153 NJ Practitioner - Physical Therapist in Private Practice 1759406168 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Light Touch Chiropractic PCGroup PAC ID 5890872162, 2 clinicians

Practice addresses (Care Compare)

400 Broadacres Dr
Suite 150
Bloomfield, NJ 07003-3156
Phone (973) 732-3444

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA01356400NJMDPhysical Therapist
021289NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Therastart LLC CurrentSince Mar 1, 2017 Accepting new patients
Light Touch Chiropractic PC CurrentSince Jul 13, 2010 Accepting new patients

Locations

400 Broadacres Dr
Ste 150
Bloomfield, NJ 07003
Phone (973) 732-3444

56 Grafton Ave
Newark, NJ 07104
Phone (201) 880-1830

56 Grafton Ave
Newark, NJ 07104
Phone (646) 667-8455

Organizations & group practices 2

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": "1237852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321833600000",
    "number": "1427290329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "827 RARITAN RD",
            "city": "SCOTCH PLAINS",
            "state": "NJ",
            "postal_code": "070762719",
            "telephone_number": "917-658-8284",
            "fax_number": "973-732-3445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 GRAFTON AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071044215",
            "telephone_number": "973-732-3444",
            "fax_number": "973-732-3445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATZ",
        "first_name": "BORIS",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-03-24",
        "last_updated": "2011-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "021289",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01356400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2011; 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.