Kassandra Reagan, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA01979800 Issued in NJ

Practice address

622 Eagle Rock Ave
West Orange, NJ 07052-2994

Phone

(973) 669-0078

NPI assigned

Nov 23, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1606089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606089600000",
    "number": "1437753209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 ROUTE 9 N STE 410",
            "city": "WOODBRIDGE",
            "state": "NJ",
            "postal_code": "070951003",
            "telephone_number": "201-801-7141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 EAGLE ROCK AVE",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070522994",
            "telephone_number": "973-669-0078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REAGAN",
        "first_name": "KASSANDRA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-23",
        "last_updated": "2020-11-23",
        "certification_date": "2020-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01979800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacklyn Yacenda Ranalli, MS, RD
• Amy Rose Rasmusson, OTR/L
• Hedwig N Ratemo, NP
• Raydiant Aesthetics & Wellness LLC
• Mark Lancel Trespalacioreal Rayos del Sol, OTR/L
• Maria L Rebelo, LCSW
• Janelle Rebustes
• Mahidhar Mahasamudram Reddy, MD
• Aimee Redisch
• Lynn R Reed, M.A., CCC-SLP

• Physical Therapist in West Orange, NJ
• Providers in West Orange, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.