Individual provider Active NPI

Leonard Jesus Somarriba

  • Orthopedic Physical Therapist
  • Aberdeen, NJ
National Provider Identifier
1629224647
Registry record updated May 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
04001234000 Issued in NJ
Practice address
1212 Highway 34
Suite 24/25
Aberdeen, NJ 07747-1903
Phone
(561) 676-3565
NPI assigned
Aug 10, 2008
Last updated
May 19, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 04001234000 NJ Primary

Addresses

Primary practice location

1212 Highway 34
Suite 24/25
Aberdeen, NJ 07747-1903

Mailing address

458 S Livingston Ave
Livingston, NJ 07039-4328
Phone (561) 676-3565

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100315000646 NJ Practitioner - Physical Therapist in Private Practice 0840325957 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Proform Physical Therapy LLCGroup PAC ID 9436383114, 18 clinicians

Practice addresses (Care Compare)

1077 State Route 34
Suite M
Aberdeen, NJ 07747-2151
Phone (732) 970-7882

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
04001234000NJMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Proform Physical Therapy LLC Orthopedic CurrentSince Aug 19, 2013 Accepting new patients
Proform Physical Therapy LLC CurrentSince Mar 7, 2013 Accepting new patients
Diego Ruiz DC LLC PastSince Oct 1, 2006 Accepting new patients
Absolute Rehab Inc PastSince Mar 14, 2016 Accepting new patients
Spectrum Physical Therapy & Athletic Training, LLC Orthopedic Past Accepting new patients

Locations

510 State Route 18
East Brunswick, NJ 08816
Phone (732) 554-8330

1921 Route 27
Edison, NJ 08817
Phone (732) 290-4511

1077 State Route 34
Ste M
Matawan, NJ 07747
Phone (732) 970-7882

1212 State Route 34
Ste 2425
Matawan, NJ 07747
Phone (732) 970-7882

1270 State Route 35
Middletown, NJ 07748
Phone (732) 615-3900

2665 Highway 516
Old Bridge, NJ 08857
Phone (732) 952-8826

Organizations & group practices 5

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": "1218326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368921600000",
    "number": "1629224647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "458 S LIVINGSTON AVE",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070394328",
            "telephone_number": "561-676-3565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 HIGHWAY 34",
            "address_2": "SUITE 24/25",
            "city": "ABERDEEN",
            "state": "NJ",
            "postal_code": "077471903",
            "telephone_number": "561-676-3565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOMARRIBA",
        "first_name": "LEONARD",
        "middle_name": "JESUS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-10",
        "last_updated": "2013-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NJ",
            "license": "04001234000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aberdeen, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2013; 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.