Individual provider Active NPI

Roland Vincent Rodriguez, MPT

  • Physical Therapist
  • Toms River, NJ
National Provider Identifier
1528199155
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA011378 Issued in NJ
Practice address
635 Bay Ave
Toms River, NJ 08753-3349
Phone
(732) 240-9296
Fax
(732) 240-9297
NPI assigned
Mar 7, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 40QA011378 NJ Primary

Addresses

Primary practice location

635 Bay Ave
Toms River, NJ 08753-3349

Mailing address

6 Pancoast Rd
Waretown, NJ 08758-2653
Phone (732) 232-3943

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090123000499 NJ Practitioner - Physical Therapist in Private Practice 1759445430 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atlantic Physical Therapy CenterGroup PAC ID 8820168123, 117 clinicians

Practice addresses (Care Compare)

1037 Route 70
Manchester, NJ 08759-5806
Phone (732) 408-1800

1372 Route 9
BLDG 2
Toms River, NJ 08755-4038
Phone (732) 240-9296

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA011378NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Atlantic Physical Therapy Center CurrentSince Dec 1, 2008 Accepting new patients
Atlantic Physical Therapy Center Physical Therapist CurrentSince Dec 1, 2008 Accepting new patients
Seashore Pediatric Therapy Center PC Past Accepting new patients

Locations

1037 Route 70
Manchester, NJ 08759
Phone (732) 408-1800

1500 Meeting House Rd
Sea Girt, NJ 08750
Phone (732) 722-8787

1372 Route 9
Bldg 2
Toms River, NJ 08755
Phone (732) 240-9296

635 Bay Ave
Toms River, NJ 08753
Phone (212) 589-2700

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": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1528199155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 PANCOAST RD",
            "city": "WARETOWN",
            "state": "NJ",
            "postal_code": "087582653",
            "telephone_number": "732-232-3943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 BAY AVE",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087533349",
            "telephone_number": "732-240-9296",
            "fax_number": "732-240-9297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "ROLAND",
        "middle_name": "VINCENT",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA011378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toms River, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.