Individual provider Active NPI

Nikita Patel, PT, DPT, OCS

  • Physical Therapist
  • Hoboken, NJ
National Provider Identifier
1508115155
Registry record updated Feb 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01702800 Issued in NJ
Practice address
1199 Hudson Street
Hoboken, NJ 07030
Phone
(201) 644-6152
NPI assigned
Aug 29, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 19, 2025

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 40QA01702800 NJ Primary

Addresses

Primary practice location

1199 Hudson Street
Hoboken, NJ 07030

Mailing address

1300 Clinton St Apt 524
Hoboken, NJ 07030-3317
Phone (646) 634-8636

Other practice location 1

1039 Avenue C
Bayonne, NJ 07002-3217
Phone (201) 437-0313

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170601000829 NJ Practitioner - Physical Therapist in Private Practice 4789820903 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2010
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)

59 Newark St
Hoboken, NJ 07030-4545
Phone (201) 654-6148

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA01702800NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Jag-One Physical Therapy, LLC Physical Therapist CurrentSince Feb 9, 2025 Accepting new patients
TLC Clove Lake Physical Therapy PC Physical Therapist Past Accepting new patients
TLC Rehabilitation Physical Therapy PC Physical Therapist PastSince Sep 1, 2006 Accepting new patients

Locations

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

59 Newark St
Hoboken, NJ 07030
Phone (201) 656-4800

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

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": "1346198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739923200000",
    "number": "1508115155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 CLINTON ST APT 524",
            "city": "HOBOKEN",
            "state": "NJ",
            "postal_code": "070303317",
            "telephone_number": "646-634-8636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1199 HUDSON STREET",
            "city": "HOBOKEN",
            "state": "NJ",
            "postal_code": "07030",
            "telephone_number": "201-644-6152"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1039 Avenue C",
            "address_purpose": "LOCATION",
            "city": "Bayonne",
            "state": "NJ",
            "postal_code": "070023217",
            "country_code": "US",
            "telephone_number": "201-437-0313",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "NIKITA",
        "credential": "PT, DPT, OCS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-29",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01702800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hoboken, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2025; 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.