Individual provider Active NPI

Mary Grace Cabawatan

  • Physical Therapist
  • Jersey City, NJ
National Provider Identifier
1497850036
Registry record updated Feb 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01096600 Issued in NJ
Practice address
610 Newark Ave
Jersey City, NJ 07306-2300
Phone
(201) 217-0600
Fax
(201) 876-5108
NPI assigned
Sep 14, 2006
Last updated
Feb 8, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2018

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 40QA01096600 NJ Primary

Addresses

Primary practice location

610 Newark Ave
Jersey City, NJ 07306-2300

Mailing address

11 Eagle Rock Ave
FL 2
East Hanover, NJ 07936-3167
Phone (201) 936-8873

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040812000802 NJ Practitioner - Physical Therapist in Private Practice 9032181680 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sportscare of America, PCGroup PAC ID 9032213756, 132 clinicians
United Sports Care and Physical TherapyGroup PAC ID 9436324886, 41 clinicians

Practice addresses (Care Compare)

550 Newark Ave
Suite 403 404
Jersey City, NJ 07030-1326
Phone (201) 217-0600

6612 -18 Bergenline Ave
West New York, NJ 07093-1719
Phone (201) 854-5511

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sportscare of America, PC Physical Therapist CurrentSince Feb 28, 2011 Accepting new patients
United Sports Care & Physical Therapy Physical Therapist CurrentSince Dec 7, 2016 Accepting new patients
Sportscare Institute, Inc. Physical Therapist Past Accepting new patients

Locations

47 S Washington Ave
Bergenfield, NJ 07621
Phone (201) 384-2525

197 Ridgedale Ave
Cedar Knolls, NJ 07927
Phone (973) 292-0700

11 Eagle Rock Ave
Fl 2
East Hanover, NJ 07936
Phone (973) 887-3000

550 Newark Ave
Ste 403404
Jersey City, NJ 07306
Phone (201) 217-0600

609 Morris Ave
Ste 2
Springfield, NJ 07081
Phone (973) 671-3200

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518048000000",
    "number": "1497850036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 EAGLE ROCK AVE",
            "address_2": "FL 2",
            "city": "EAST HANOVER",
            "state": "NJ",
            "postal_code": "079363167",
            "telephone_number": "201-936-8873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 NEWARK AVE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073062300",
            "telephone_number": "201-217-0600",
            "fax_number": "201-876-5108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CABAWATAN",
        "first_name": "MARY GRACE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-14",
        "last_updated": "2018-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01096600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jersey City, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2018; 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.