Individual provider Active NPI

Tyler Calimer

  • Physical Therapist
  • Egg Harbor Township, NJ
National Provider Identifier
1477286276
Registry record updated Jul 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA02100500 Issued in NJ
Practice address
2500 English Creek Ave
Egg Harbor Township, NJ 08234-5549
Phone
(609) 677-7268
NPI assigned
Jul 8, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 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 40QA02100500 NJ Primary

Addresses

Primary practice location

2500 English Creek Ave
Egg Harbor Township, NJ 08234-5549

Mailing address

602 Parker Ave
Egg Harbor City, NJ 08215-3758
Phone (609) 464-2468

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220819000056 NJ Practitioner - Physical Therapist in Private Practice 3476936766 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Champion Rehabilitation LLCGroup PAC ID 8224252556, 4 clinicians
Strive Physical Therapy Specialists LLCGroup PAC ID 6709292535, 163 clinicians

Practice addresses (Care Compare)

2500 English Creek Ave
Lifecenter 2ND Floor
Egg Harbor Township, NJ 08234-5549
Phone (609) 677-7268

415 W Landis Ave
Suite 101a
Vineland, NJ 08360-8135
Phone (856) 500-3800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA02100500NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Champion Rehabilitation LLC Physical Therapist CurrentSince Jul 22, 2022 Accepting new patients

Locations

2500 English Creek Ave
Fl 2
Egg Hbr Twp, NJ 08234
Phone (609) 677-7268

2500 English Creek Ave
Egg Hbr Twp, NJ 08234
Phone (609) 407-0021

Organizations & group practices 2

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": "1657238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657238400000",
    "number": "1477286276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 PARKER AVE",
            "city": "EGG HARBOR CITY",
            "state": "NJ",
            "postal_code": "082153758",
            "telephone_number": "609-464-2468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 ENGLISH CREEK AVE",
            "city": "EGG HARBOR TOWNSHIP",
            "state": "NJ",
            "postal_code": "082345549",
            "telephone_number": "609-677-7268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALIMER",
        "first_name": "TYLER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-08",
        "last_updated": "2022-07-08",
        "certification_date": "2022-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA02100500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Egg Harbor Township, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2022; 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.