Individual provider Active NPI

Bruce Stamper, PT

  • Physical Therapist
  • East Hanover, NJ
National Provider Identifier
1457477887
Registry record updated Apr 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT4437 Issued in FL
Practice address
11 Eagle Rock Ave Ste 103
East Hanover, NJ 07936-3167
Phone
(973) 887-9000
Fax
(973) 887-3816
NPI assigned
Mar 21, 2007
Last updated
Apr 6, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2022

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 PT4437 FL Primary

Addresses

Primary practice location

11 Eagle Rock Ave Ste 103
East Hanover, NJ 07936-3167

Mailing address

11 Eagle Rock Ave Ste 103
East Hanover, NJ 07936-3167
Phone (973) 887-9000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220411000008 FL Practitioner - Physical Therapist in Private Practice 7416361829 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sportscare Institute, LLC Physical Therapist CurrentSince Apr 6, 2022 Accepting new patients
Rehabcare Group East, LLC Past Accepting new patients
H2 Rehabilitation Services of Florida LLC Past Accepting new patients
Sportscare of America, PC Physical Therapist PastSince Apr 10, 2022 Accepting new patients

Locations

3716 University Blvd S
Ste 4
Jacksonville, FL 32216
Phone (904) 733-8133

7408 Lake Worth Rd
Ste 500
Lake Worth, FL 33467
Phone (561) 432-3693

231 N New York Ave
Winter Park, FL 32789
Phone (407) 599-3700

11 Eagle Rock Ave
Ste 201
East Hanover, NJ 07936
Phone 9738879000351

Organizations & group practices 4

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": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649203200000",
    "number": "1457477887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 EAGLE ROCK AVE STE 103",
            "city": "EAST HANOVER",
            "state": "NJ",
            "postal_code": "079363167",
            "telephone_number": "973-887-9000",
            "fax_number": "973-887-3816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 EAGLE ROCK AVE STE 103",
            "city": "EAST HANOVER",
            "state": "NJ",
            "postal_code": "079363167",
            "telephone_number": "973-887-9000",
            "fax_number": "973-887-3816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAMPER",
        "first_name": "BRUCE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-21",
        "last_updated": "2022-04-06",
        "certification_date": "2022-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT4437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Hanover, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2022; 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.