Individual provider Active NPI

Vini Jain

  • Physical Therapist
  • Freehold, NJ
National Provider Identifier
1427470616
Registry record updated Jan 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01531900 Issued in GA
Practice address
1102 Morven CT
Freehold, NJ 07728-4843
Phone
(646) 288-8424
NPI assigned
Jan 8, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2014

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 40QA01531900 GA Primary
Physical Therapist 225100000X 1228532 GA

Addresses

Primary practice location

1102 Morven CT
Freehold, NJ 07728-4843

Mailing address

1102 Morven CT
Freehold, NJ 07728-4843
Phone (646) 288-8424

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220914001911 NJ Practitioner - Physical Therapist in Private Practice 6800271677

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1228532GAMDPhysical Therapist
40QA01531900GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
At Home by Enhance Therapies LLC Physical Therapist CurrentSince Aug 1, 2022 Accepting new patients

Locations

411 Hackensack Ave
Ste 200
Hackensack, NJ 07601
Phone (732) 987-3833

400 Route 70
Lakewood, NJ 08701
Phone (732) 802-7512

Organizations & group practices 1

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": "1389139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389139200000",
    "number": "1427470616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1102 MORVEN CT",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077284843",
            "telephone_number": "646-288-8424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 MORVEN CT",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077284843",
            "telephone_number": "646-288-8424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAIN",
        "first_name": "VINI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-08",
        "last_updated": "2014-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "40QA01531900",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "1228532",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Freehold, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2014; 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.