Organization Active NPI

Prime Care Physical Therapy LLC

  • Physical Therapy Clinic/Center
  • Old Bridge, NJ
National Provider Identifier
1487263109
Registry record updated Aug 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
PRIME CARE PHYSICAL THERAPY LLC
Practice address
109 White Oak LN Ste 54
Old Bridge, NJ 08857-1981
Phone
(732) 679-7878
Fax
(732) 679-4332
NPI assigned
Jul 28, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Neetaben M KhuntNPI 1023407731
Title
Physical Therapist
Phone
(708) 663-9200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

109 White Oak LN Ste 54
Old Bridge, NJ 08857-1981

Mailing address

109 White Oak LN Ste 54
Old Bridge, NJ 08857-1981
Phone (732) 679-7878

Other names 1

  • Old Bridge Physical Therapy Associates Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201007001849 NJ Part B Supplier - Clinic/Group Practice 7214356443 Receives reassigned benefits from 2 practitioners
Practice locations: Old Bridge, NJ

National Provider Directory

National Provider Directory

Locations

105 White Oak Ln
Ste 103
Old Bridge, NJ 08857
Phone (708) 663-9200

109 White Oak Ln
Ste 54
Old Bridge, NJ 08857
Phone (708) 663-9200

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1595894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724371200000",
    "number": "1487263109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 WHITE OAK LN STE 54",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "088571981",
            "telephone_number": "732-679-7878",
            "fax_number": "732-679-4332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 WHITE OAK LN STE 54",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "088571981",
            "telephone_number": "732-679-7878",
            "fax_number": "732-679-4332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME CARE PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-28",
        "last_updated": "2024-08-23",
        "certification_date": "2024-08-23",
        "status": "A",
        "authorized_official_last_name": "KHUNT",
        "authorized_official_first_name": "NEETABEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "708-663-9200"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Old Bridge Physical Therapy Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Old Bridge Physical Therapy Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Old Bridge, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2024; 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.