Individual provider Active NPI

Jonathan J Moshenberg, DPT

  • Physical Therapist
  • Watchung, NJ
National Provider Identifier
1477784478
Registry record updated Aug 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01397400 Issued in NJ
Practice address
459 Watchung Ave
Suite LL4
Watchung, NJ 07069-4945
Phone
(908) 756-2424
Fax
(908) 756-2447
NPI assigned
Aug 7, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2016

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 40QA01397400 NJ Primary

Addresses

Primary practice location

459 Watchung Ave
Suite LL4
Watchung, NJ 07069-4945

Mailing address

459 Watchung Ave
Suite LL4
Watchung, NJ 07069-4945
Phone (908) 756-2424

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110913000702 NJ Practitioner - Physical Therapist in Private Practice 7214082171 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ivyrehab Network IncGroup PAC ID 3476539776, 658 clinicians

Practice addresses (Care Compare)

525 Central Ave
Westfield, NJ 07090-2534
Phone (908) 654-4252

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA01397400NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Performance Medical Group of Branchburg LLC CurrentSince Jan 4, 2024 Accepting new patients
Ivyrehab Network Inc. Physical Therapist Current Accepting new patients
Ivyrehab Network Inc Physical Therapist CurrentSince May 22, 2023 Accepting new patients
Performance Medical Group of Somerset CurrentSince Jan 1, 2021 Accepting new patients
Ivyrehab Network, Inc. Physical Therapist CurrentSince May 22, 2023 Accepting new patients
Performance Medical of Watchung LLC CurrentSince Jan 1, 2019 Accepting new patients
Great Hands Inc Physical Therapist Past Accepting new patients

Locations

3150 US Highway 22
Branchburg, NJ 08876
Phone (908) 552-0996

3150 US Highway 22
Ste 1
Branchburg, NJ 08876
Phone 9087562424131

1011 US Highway 22
Ste 203
Bridgewater, NJ 08807
Phone 9087562424135

1011 US Highway 22
Bridgewater, NJ 08807

731 Lacey Rd
Ste 3
Forked River, NJ 08731
Phone (609) 242-6780

454 Passaic St
Hackensack, NJ 07601
Phone (201) 488-7905

454 Elizabeth Ave
Somerset, NJ 08873
Phone (732) 319-0132

505 Morris Ave
Ste 103
Springfield, NJ 07081
Phone (973) 379-7006

459 Watchung Ave
Watchung, NJ 07069
Phone (908) 274-0988

459 Watchung Ave
Ste LL4
Watchung, NJ 07069

10 Johnston Dr
Watchung, NJ 07069

Organizations & group practices 7

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": "1249603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471305600000",
    "number": "1477784478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "459 WATCHUNG AVE",
            "address_2": "SUITE LL4",
            "city": "WATCHUNG",
            "state": "NJ",
            "postal_code": "070694945",
            "telephone_number": "908-756-2424",
            "fax_number": "908-756-2447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "459 WATCHUNG AVE",
            "address_2": "SUITE LL4",
            "city": "WATCHUNG",
            "state": "NJ",
            "postal_code": "070694945",
            "telephone_number": "908-756-2424",
            "fax_number": "908-756-2447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSHENBERG",
        "first_name": "JONATHAN",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-07",
        "last_updated": "2016-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01397400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watchung, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2016; 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.