Individual provider Active NPI

Robert James Roller Jr., P.T.

  • Orthopedic Physical Therapist
  • Marmora, NJ
National Provider Identifier
1457048605
Registry record updated Apr 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
40QA00508900 Issued in NJ
Practice address
220 N Shore Rd
Marmora, NJ 08223-1545
Phone
(609) 425-4130
NPI assigned
Apr 19, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 19, 2023

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 40QA00508900 NJ Primary

Addresses

Primary practice location

220 N Shore Rd
Marmora, NJ 08223-1545

Mailing address

220 N Shore Rd
Marmora, NJ 08223-1545
Phone (609) 425-4130

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230717000092 NJ Practitioner - Physical Therapist in Private Practice 7810357332 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osprey Rehabilitation LLCGroup PAC ID 7214302264, 54 clinicians

Practice addresses (Care Compare)

210 S Shore Rd
Suite 203
Marmora, NJ 08223-1263
Phone (609) 390-2400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA00508900NJMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Osprey Rehabilitation, LLC. Orthopedic Current Accepting new patients
Osprey Rehabilitation, LLC. CurrentSince May 21, 2023 Accepting new patients
Osprey Rehabilitation, LLC. CurrentSince May 21, 2023 Accepting new patients

Organizations & group practices 3

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": "1681862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681862400000",
    "number": "1457048605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 N SHORE RD",
            "city": "MARMORA",
            "state": "NJ",
            "postal_code": "082231545",
            "telephone_number": "609-425-4130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 N SHORE RD",
            "city": "MARMORA",
            "state": "NJ",
            "postal_code": "082231545",
            "telephone_number": "609-425-4130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROLLER",
        "first_name": "ROBERT",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-04-19",
        "last_updated": "2023-04-19",
        "certification_date": "2023-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NJ",
            "license": "40QA00508900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marmora, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2023; 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.