Justin Gardner, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA01718800 Issued in NJ

Practice address

1719 Main St
Lake Como, NJ 07719-3097

Phone

(732) 894-9200

Fax

(732) 894-9202

NPI assigned

Mar 2, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Barnegat Sports Rehabilitation and Physical Therapy LLCGroup PAC ID 8628151693, 13 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

85.61 of 100Reported as group

Quality

81.84

Improvement activities

40

Cost

76.23

Medicare enrollment (NPD)

Enrolled

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

• Barnegat Sports Rehabilitation & Physical Therapy LLC

  • Physical Therapy Clinic/Center
  • Barnegat, NJ
  • NPI 1477617405

  Physical Therapist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1488412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488412800000",
    "number": "1528508041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1719 MAIN ST",
            "city": "LAKE COMO",
            "state": "NJ",
            "postal_code": "077193097",
            "telephone_number": "732-894-9200",
            "fax_number": "732-894-9202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1719 MAIN ST",
            "city": "LAKE COMO",
            "state": "NJ",
            "postal_code": "077193097",
            "telephone_number": "732-894-9200",
            "fax_number": "732-894-9202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "JUSTIN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-02",
        "last_updated": "2017-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01718800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT LICENSE",
            "identifier": "40QA01718800",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vincent Cavaliere
• Joshua N Chu, PT, DPT
• Gina Dehmer
• Epic Medical Staffing, LLC
• Benjamin Fan, PT, DPT
• Genesis Integrative Medicine Longevity Center LLC
• Charlene L. Griffin, M.T.
• Gulotta Chiropractic
• Gulotta Chiropractic
• Joseph James Gulotta, DC

• Physical Therapist in Lake Como, NJ
• Providers in Lake Como, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2017; 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.