Thomas Supko Jr.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA02366300 Issued in NJ

Practice address

266 Harristown Rd
Glen Rock, NJ 07452-3302

Phone

(201) 445-7000

NPI assigned

Sep 6, 2025

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Sportsmed PT LLC

  • Physical Therapist
  • Glen Rock, NJ
  • NPI 1841787645

  NJ, Single Specialty

  Medicare reassignment Care Compare group NPD

Specialty

Physical Therapist in Private Practice

Education

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sportsmed PT LLC 183 clinicians

Practice addresses (Care Compare)

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

{
    "created_epoch": "1757116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761264000000",
    "number": "1508746751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 1ST ST",
            "city": "OAKLAND",
            "state": "NJ",
            "postal_code": "074362001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "266 HARRISTOWN RD",
            "city": "GLEN ROCK",
            "state": "NJ",
            "postal_code": "074523302",
            "telephone_number": "201-445-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUPKO",
        "first_name": "THOMAS",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-09-06",
        "last_updated": "2025-10-24",
        "certification_date": "2025-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA02366300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Glen Rock, NJ
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 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.