Active NPI
Kimberly Hermoza, DPT
- Physical Therapist
- Matawan, NJ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 40QA02130200
- Practice address
- 144 Route 34
Matawan, NJ 07747-2132 - Phone
- (732) 320-6285
- Fax
- (732) 374-9864
- NPI assigned
- Sep 23, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 40QA02130200 | NJ | Primary |
Addresses
Primary practice location
144 Route 34
Matawan, NJ 07747-2132
Mailing address
144 Route 34
Matawan, NJ 07747-2132
Phone (732) 320-6285
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 40QA02130200 | Other | NJ | LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
728 Bennetts Mills Rd
Jackson, NJ 08527-3850
Phone (732) 415-1401
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40QA02130200 | NJ | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advanced Spine Care and Physical Rehabilitation,LLC | Current | Accepting new patients | |
| Old Bridge Spine & Wellness Center,PA | Physical Therapist | Current | Accepting new patients |
Locations
2080 W County Line Rd
Jackson, NJ 08527
Phone (732) 364-5123
728 Bennetts Mills Rd
Jackson, NJ 08527
Phone (732) 415-1401
728 Bennetts Mills Rd
Ste 1
Jackson, NJ 08527
Phone (732) 415-1401
144 State Route 34
Matawan, NJ 07747
Phone (732) 316-5895
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 and National Provider Directory roles.
-
- Multi-Specialty Clinic/Center
- Jackson, NJ
- NPI 1891816914
-
- Rehabilitation Chiropractor
- Matawan, NJ
- NPI 1487885141
Physical Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1663891200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663891200000",
"number": "1679296636",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "144 ROUTE 34",
"city": "MATAWAN",
"state": "NJ",
"postal_code": "077472132",
"telephone_number": "732-320-6285",
"fax_number": "732-374-9864"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "144 ROUTE 34",
"city": "MATAWAN",
"state": "NJ",
"postal_code": "077472132",
"telephone_number": "732-320-6285",
"fax_number": "732-374-9864"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERMOZA",
"first_name": "KIMBERLY",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-09-23",
"last_updated": "2022-09-23",
"certification_date": "2022-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NJ",
"license": "40QA02130200",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "40QA02130200",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Matawan, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2022; 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.