NPIMap

Organization Active NPI

Trinity Rehab Somerset PA

Doing business as Trinity Rehab Clifton

  • Physical Medicine & Rehabilitation Physician
  • Clifton, NJ
National Provider Identifier
1609489954
Registry record updated Aug 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
TRINITY REHAB SOMERSET PA
Doing business as
Trinity Rehab Clifton
Practice address
852 Route 3 Ste 246
Clifton, NJ 07012-2344
Phone
(732) 219-5700
Fax
(732) 334-3004
NPI assigned
Aug 26, 2020
Last updated
Aug 26, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
TRINITY REHAB SOMERSET PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 26, 2020

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

Authorized official

Name
Tonya Gavrielides
Title
Office Manager
Phone
(732) 219-5700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X Primary

Addresses

Primary practice location

852 Route 3 Ste 246
Clifton, NJ 07012-2344

Mailing address

554 Highway 35
Red Bank, NJ 07701-5066
Phone (732) 219-5700

Other names 1

  • Trinity Rehab Clifton Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170113000019 NJ Part B Supplier - Physical/Occupational Therapy Group in Private Practice 0547540809 Receives reassigned benefits from 136 practitioners
37 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Piscataway, NJ; Morristown, NJ; Red Bank, NJ; Sewell, NJ; Short Hills, NJ; Shrewsbury, NJ; Somers Point, NJ; Somerset, NJ…

Other NPIs on the same Medicare enrollment 37

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 37

National Provider Directory

National Provider Directory
Tax ID family
Trinity Rehab Somerset PA34 organizations share this tax ID, including this one
Part of
Trinity Rehab Somerset PA

Other organizations with this tax ID 33

Organizations that report the same tax identification number in the National Provider Directory.

View all 33

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1598400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598400000000",
    "number": "1609489954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "554 HIGHWAY 35",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077015066",
            "telephone_number": "732-219-5700",
            "fax_number": "732-334-3004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "852 ROUTE 3 STE 246",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070122344",
            "telephone_number": "732-219-5700",
            "fax_number": "732-334-3004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRINITY REHAB SOMERSET PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TRINITY REHAB SOMERSET PA",
        "enumeration_date": "2020-08-26",
        "last_updated": "2020-08-26",
        "certification_date": "2020-08-26",
        "status": "A",
        "authorized_official_last_name": "GAVRIELIDES",
        "authorized_official_first_name": "TONYA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "732-219-5700"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Trinity Rehab Clifton",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clifton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.