Individual provider Active NPI

Shonda Robinson, DPT

  • Physical Therapist
  • Edison, NJ
National Provider Identifier
1477084705
Registry record updated Nov 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01475400 Issued in NJ
Practice address
629 Amboy Avenue, Edison, NJ, USA
Suite 002
Edison, NJ 08837-3579
Phone
(732) 661-1500
Fax
(732) 661-1505
NPI assigned
Mar 27, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2019

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 40QA01475400 NJ Primary

Addresses

Primary practice location

629 Amboy Avenue, Edison, NJ, USA
Suite 002
Edison, NJ 08837-3579

Mailing address

629 Amboy Avenue, Edison, NJ, USA
Suite 002
Edison, NJ 08837-3579

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180312001042 NJ Practitioner - Physical Therapist in Private Practice 1658632526 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tri-Pro Physical Therapy LLCGroup PAC ID 6204197171, 3 clinicians

Practice addresses (Care Compare)

629 Amboy Ave
Suite 2
Edison, NJ 08837-3579
Phone (732) 661-1500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Tri-Pro Physical Therapy LLC Physical Therapist CurrentSince Dec 1, 2017 Accepting new patients

Locations

629 Amboy Ave
Ste 2
Edison, NJ 08837
Phone (732) 485-3990

Organizations & group practices 1

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": "1490572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574035200000",
    "number": "1477084705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "629 AMBOY AVENUE, EDISON, NJ, USA",
            "address_2": "SUITE 002",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088373579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "629 AMBOY AVENUE, EDISON, NJ, USA",
            "address_2": "SUITE 002",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088373579",
            "telephone_number": "732-661-1500",
            "fax_number": "732-661-1505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBINSON",
        "first_name": "SHONDA",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-27",
        "last_updated": "2019-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01475400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edison, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2019; 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.