Individual provider Active NPI

Jason P Carelis, PT, DPT

  • Physical Therapist
  • Lincoln Park, NJ
National Provider Identifier
1477812808
Registry record updated Feb 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01440600 Issued in NJ
Practice address
212 Main St Ste B
Lincoln Park, NJ 07035-1786
Phone
(973) 696-2999
Fax
(732) 855-9755
NPI assigned
May 4, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2020

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 40QA01440600 NJ Primary

Addresses

Primary practice location

212 Main St Ste B
Lincoln Park, NJ 07035-1786

Mailing address

PO Box 1014
Clark, NJ 07066-1014
Phone (732) 855-9751

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120521000106 NJ Practitioner - Physical Therapist in Private Practice 6901069483 Reassigns benefits to 2 organizations

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
Jag-One Physical Therapy LLCGroup PAC ID 2769584325, 334 clinicians

Practice addresses (Care Compare)

2107 Route 35
Holmdel, NJ 07733-2795
Phone (732) 856-9791

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Jag-One Physical Therapy, LLC Physical Therapist CurrentSince May 15, 2023 Accepting new patients
Twin Boro Physical Therapy Associates PA Physical Therapist CurrentSince May 14, 2012 Accepting new patients
Twin Boro Physical Therapy Associates, PA CurrentSince May 14, 2012 Accepting new patients

Locations

981 US Highway 22
Fl 2
Bridgewater, NJ 08807
Phone (908) 231-0511

20 Commerce Dr
Ste 210
Cranford, NJ 07016

244 Route 46 E
Fairfield, NJ 07004
Phone (862) 702-3420

2107 State Route 35
Holmdel, NJ 07733
Phone (732) 587-5065

212 Main St
Ste B
Lincoln Park, NJ 07035
Phone (201) 788-7218

2050 State Route 27
Ste 107
North Brunswick, NJ 08902
Phone (732) 745-2727

221 Rockingham Row
Princeton, NJ 08540
Phone (609) 580-1520

622 Eagle Rock Ave
West Orange, NJ 07052
Phone (973) 669-0078

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": "1336089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582848000000",
    "number": "1477812808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1014",
            "city": "CLARK",
            "state": "NJ",
            "postal_code": "070661014",
            "telephone_number": "732-855-9751",
            "fax_number": "732-855-9755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 MAIN ST STE B",
            "city": "LINCOLN PARK",
            "state": "NJ",
            "postal_code": "070351786",
            "telephone_number": "973-696-2999",
            "fax_number": "732-855-9755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARELIS",
        "first_name": "JASON",
        "middle_name": "P",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-04",
        "last_updated": "2020-02-28",
        "certification_date": "2020-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01440600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln Park, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2020; 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.