Individual provider Active NPI

Mark Brumer, PT

  • Physical Therapist
  • East Brunswick, NJ
National Provider Identifier
1568501385
Registry record updated May 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
QA01030800 Issued in NJ
Practice address
G11 Brier Hill CT
East Brunswick, NJ 08816-3338
Phone
(732) 698-7108
Fax
(732) 698-7105
NPI assigned
Feb 6, 2007
Last updated
May 18, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2015

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 QA01030800 NJ Primary

Addresses

Primary practice location

G11 Brier Hill CT
East Brunswick, NJ 08816-3338

Mailing address

G11 Brier Hill CT
East Brunswick, NJ 08816-3338
Phone (732) 698-7108

Other identifiers 1

IdentifierTypeStateIssuer
1563394OtherNJAMERIHEALTH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090923000805 NJ Practitioner - Physical Therapist in Private Practice 0648363887 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

G11 Brier Hill CT
East Brunswick, NJ 08816-3338
Phone (732) 698-7108

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
QA01030800NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Classic Family Rehabilitation, LLC Physical Therapist CurrentSince Mar 2, 2009 Accepting new patients
Healthy Body Rehabilitation PC Physical Therapist PastSince Jun 11, 2007 Accepting new patients

Locations

G11 Brier Hill Ct
East Brunswick, NJ 08816
Phone (732) 698-0082

Organizations & group practices 2

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": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431907200000",
    "number": "1568501385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "G11 BRIER HILL CT",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088163338",
            "telephone_number": "732-698-7108",
            "fax_number": "732-698-7105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "G11 BRIER HILL CT",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088163338",
            "telephone_number": "732-698-7108",
            "fax_number": "732-698-7105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUMER",
        "first_name": "MARK",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-06",
        "last_updated": "2015-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "QA01030800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "1563394",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Brunswick, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2015; 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.