Individual provider Active NPI

Regina Marie Wagar

  • Physical Therapist
  • Oceanport, NJ
National Provider Identifier
1427855261
Registry record updated Feb 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA02319900 Issued in NJ
Practice address
100 Sanger Avenue, Fort Monmouth
Russel Hall, Suite 125
Oceanport, NJ 07703
Phone
(732) 380-7335
NPI assigned
Feb 28, 2025
Last updated
Feb 28, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2025

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 40QA02319900 NJ Primary

Addresses

Primary practice location

100 Sanger Avenue, Fort Monmouth
Russel Hall, Suite 125
Oceanport, NJ 07703

Mailing address

39 Highland Ave
Monmouth Beach, NJ 07750-1010

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250318003852 NJ Practitioner - Physical Therapist in Private Practice 7517489636 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ipta Clinical, LLCGroup PAC ID 0749456119, 126 clinicians

Practice addresses (Care Compare)

1000 Sanger Ave
Oceanport, NJ 07757-1241
Phone (732) 255-7404

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA02319900NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ipta Clinical, LLC Physical Therapist CurrentSince Mar 17, 2025 Accepting new patients
3 Dimensional Physical Therapy - Pelvic Health LLC Physical Therapist PastSince Feb 23, 2025 Accepting new patients

Locations

175 Route 70
Ste 19
Medford, NJ 08055
Phone (609) 257-3750

1000 Sanger Ave
Ste 125
Oceanport, NJ 07757
Phone (732) 255-7404

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": "1740700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740700800000",
    "number": "1427855261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 HIGHLAND AVE",
            "city": "MONMOUTH BEACH",
            "state": "NJ",
            "postal_code": "077501010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SANGER AVENUE, FORT MONMOUTH",
            "address_2": "RUSSEL HALL, SUITE 125",
            "city": "OCEANPORT",
            "state": "NJ",
            "postal_code": "07703",
            "telephone_number": "732-380-7335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGAR",
        "first_name": "REGINA",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-28",
        "last_updated": "2025-02-28",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA02319900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oceanport, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2025; 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.