Individual provider Active NPI

Jaden Hoth

  • Physical Therapist
  • Vineland, NJ
National Provider Identifier
1578204616
Registry record updated Sep 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA02087500 Issued in NJ
Practice address
1940 S West Blvd BLDG a
Vineland, NJ 08360-7024
Phone
(856) 690-9977
Fax
(856) 507-9918
NPI assigned
Apr 5, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2023

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 40QA02087500 NJ Primary

Addresses

Primary practice location

1940 S West Blvd BLDG a
Vineland, NJ 08360-7024

Mailing address

1311 Mamaroneck Ave Ste 140
White Plains, NY 10605-5224
Phone (914) 294-4050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, NJ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220419001834 OR Practitioner - Physical Therapist in Private Practice 6305233487 Reassigns benefits to 1 organization
I20220727001088 NJ Practitioner - Physical Therapist in Private Practice 6305233487 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ivyrehab Network IncGroup PAC ID 3476539776, 658 clinicians

Practice addresses (Care Compare)

1940 S W Blvd
BLDG a
Vineland, NJ 08360-7024
Phone (856) 690-9977

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA02087500NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ivyrehab Network, Inc. Physical Therapist CurrentSince Jul 5, 2022 Accepting new patients
Ivyrehab Network Inc. Physical Therapist CurrentSince Jul 5, 2022 Accepting new patients
Erhardt Physical Therapy and Sports Medicine, LLC Physical Therapist CurrentSince Mar 28, 2022 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

731 Lacey Rd
Ste 3
Forked River, NJ 08731
Phone (609) 242-6780

454 Passaic St
Hackensack, NJ 07601
Phone (201) 488-7905

108 Bilby Rd
Ste 201
Hackettstown, NJ 07840
Phone (908) 684-5646

1940 S West Blvd
Bldg A
Vineland, NJ 08360
Phone (856) 690-9977

1311 Mamaroneck Ave
Ste 140
White Plains, NY 10605
Phone (914) 265-4838

735 SW 158th Ave
Ste 160
Beaverton, OR 97006
Phone (503) 597-0035

3165 Commercial St SE
Ste 101102
Salem, OR 97302
Phone (503) 566-7700

51385 SW Old Portland Rd
Scappoose, OR 97056
Phone (503) 543-7768

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1649116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695859200000",
    "number": "1578204616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 MAMARONECK AVE STE 140",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106055224",
            "telephone_number": "914-294-4050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1940 S WEST BLVD BLDG A",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083607024",
            "telephone_number": "856-690-9977",
            "fax_number": "856-507-9918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOTH",
        "first_name": "JADEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-05",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA02087500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vineland, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2023; 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.