Individual provider Active NPI

Jeff Grinkovitch, MPT

  • Orthopedic Physical Therapist
  • Dumont, NJ
National Provider Identifier
1447348990
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
40QA01134300 Issued in NJ
Practice address
125 Washington Ave
Dumont, NJ 07628-3066
Phone
(201) 385-6272
NPI assigned
Oct 10, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 40QA01134300 NJ Primary

Addresses

Primary practice location

125 Washington Ave
Dumont, NJ 07628-3066

Mailing address

14 Ruckner Rd
Westwood, NJ 07675-3308
Phone (201) 594-1118

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080826000590 NJ Practitioner - Physical Therapist in Private Practice 8628143674 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Greenwood Ave
Montclair, NJ 07042-3649
Phone (973) 746-2424

182 Kinderkamack Rd
Park Ridge, NJ 07656-1331
Phone (551) 390-3171

440 Old Hook Rd
Emerson, NJ 07630-2302
Phone (201) 497-6752

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA01134300NJMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Occupational & Physical Therapy, PLLC CurrentSince May 1, 2017 Accepting new patients
Professional Occupational & Physical Therapy, PLLC Orthopedic Current Accepting new patients
Rothman Orthopaedics of New Jersey, LLC CurrentSince Sep 3, 2019 Accepting new patients
Professional Occupational & Physical Therapy, PLLC CurrentSince May 1, 2017 Accepting new patients
Rothman Institute of New Jersey, P.a. CurrentSince Sep 3, 2019 Accepting new patients
Mam Orthopaedics, PA PastSince Oct 18, 2010 Accepting new patients

Locations

999 Route 73 N
Ste 401
Marlton, NJ 08053
Phone (609) 617-3546

1 Greenwood Ave
Montclair, NJ 07042
Phone (973) 746-2424

524 Williamstown Rd
Ste B1
Sicklerville, NJ 08081
Phone (856) 516-0591

68 River Rd
Summit, NJ 07901
Phone (908) 277-0800

1500 Pleasant Valley Way
Ste 102
West Orange, NJ 07052
Phone (973) 325-3422

576 Broadhollow Rd
Melville, NY 11747

Organizations & group practices 6

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": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1447348990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 RUCKNER RD",
            "city": "WESTWOOD",
            "state": "NJ",
            "postal_code": "076753308",
            "telephone_number": "201-594-1118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 WASHINGTON AVE",
            "city": "DUMONT",
            "state": "NJ",
            "postal_code": "076283066",
            "telephone_number": "201-385-6272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRINKOVITCH",
        "first_name": "JEFF",
        "name_prefix": "Mr.",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NJ",
            "license": "40QA01134300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dumont, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.