Individual provider Active NPI

Jeanette Q Mayer, PT

  • Physical Therapist
  • Mountain Lakes, NJ
National Provider Identifier
1609971936
Registry record updated Jan 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
QA01067800 Issued in NJ
Practice address
27 Ronarm Dr
Mountain Lakes, NJ 07046-1422
Phone
(856) 628-6395
NPI assigned
Sep 13, 2006
Last updated
Jan 25, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2019

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 QA01067800 NJ Primary

Addresses

Primary practice location

27 Ronarm Dr
Mountain Lakes, NJ 07046-1422

Mailing address

27 Ronarm Dr
Mountain Lakes, NJ 07046-1422
Phone (856) 628-6395

Other practice location 1

443 Laurel Oak Rd
suite 200
Voorhees, NJ 08043-4451
Phone (856) 741-7400

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190313000051 NJ Practitioner - Physical Therapist in Private Practice 5496095333 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mpower Physical Therapy LLCGroup PAC ID 4587904420, 2 clinicians

Practice addresses (Care Compare)

27 Ronarm Dr
Mountain Lakes, NJ 07046-1422
Phone (856) 628-6395

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
QA01067800NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mpower Physical Therapy LLC Physical Therapist CurrentSince Jan 4, 2019 Accepting new patients
Magee-Mossrehab at Voorhees Physical Therapist Past Accepting new patients

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": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548374400000",
    "number": "1609971936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 RONARM DR",
            "city": "MOUNTAIN LAKES",
            "state": "NJ",
            "postal_code": "070461422",
            "telephone_number": "856-628-6395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 RONARM DR",
            "city": "MOUNTAIN LAKES",
            "state": "NJ",
            "postal_code": "070461422",
            "telephone_number": "856-628-6395"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "443 Laurel Oak Rd",
            "address_2": "suite 200",
            "address_purpose": "LOCATION",
            "city": "Voorhees",
            "state": "NJ",
            "postal_code": "080434451",
            "country_code": "US",
            "telephone_number": "856-741-7400",
            "fax_number": "856-741-0109",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAYER",
        "first_name": "JEANETTE",
        "middle_name": "Q",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-13",
        "last_updated": "2019-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "QA01067800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain Lakes, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2019; 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.