Individual provider Active NPI

Jaime M Gamatero Jr., P.T.

  • Physical Therapist
  • Forest Hills, NY
National Provider Identifier
1508132010
Registry record updated Mar 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
027029 Issued in NY
Practice address
11051 62ND Dr
2F
Forest Hills, NY 11375-1234
Phone
(347) 968-8658
Fax
(718) 679-9653
NPI assigned
Mar 29, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 027029 NY Primary
Physical Therapist 225100000X 40QA01299200 NJ

Addresses

Primary practice location

11051 62ND Dr
2F
Forest Hills, NY 11375-1234

Mailing address

11051 62ND Dr
2F
Forest Hills, NY 11375-1234
Phone (646) 642-6598

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180426000646 NY Practitioner - Physical Therapist in Private Practice 8325302466 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fox Rehabilitation Physical Therapy Services LLCGroup PAC ID 1355395179, 226 clinicians

Practice addresses (Care Compare)

1844 2ND Ave
New York, NY 10128-3862
Phone (877) 407-3422

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA01299200NJMDPhysical Therapist
027029NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Rehabilitation Physical Therapy Services LLC Physical Therapist CurrentSince Apr 20, 2018 Accepting new patients

Locations

7 Carnegie Plz
Cherry Hill, NJ 08003

1415 Richmond Ave
Staten Island, NY 10314
Phone (212) 475-5540

Organizations & group practices 1

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": "1332979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332979200000",
    "number": "1508132010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11051 62ND DR",
            "address_2": "2F",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113751234",
            "telephone_number": "646-642-6598",
            "fax_number": "718-679-9653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11051 62ND DR",
            "address_2": "2F",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113751234",
            "telephone_number": "347-968-8658",
            "fax_number": "718-679-9653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMATERO",
        "first_name": "JAIME",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-03-29",
        "last_updated": "2012-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "027029",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01299200",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2012; 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.