Individual provider Active NPI

Anthony Aubrey McPherson

  • Physical Therapist
  • Newark, NJ
National Provider Identifier
1700423241
Registry record updated Dec 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01905200 Issued in NJ
Practice address
902 N 5TH St # C104
Newark, NJ 07107-4804
Phone
(973) 910-2300
NPI assigned
Dec 3, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 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 40QA01905200 NJ Primary

Addresses

Primary practice location

902 N 5TH St # C104
Newark, NJ 07107-4804

Mailing address

380 Mount Prospect Ave Apt 1a
Newark, NJ 07104-2128

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200116001711 NJ Practitioner - Physical Therapist in Private Practice 2668807884 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Elite Physical Therapy LLCGroup PAC ID 9335370923, 3 clinicians
Elite PT LLCGroup PAC ID 7810385424, 2 clinicians

Practice addresses (Care Compare)

198 Market St
Suite 208
Newark, NJ 07102-3708
Phone (973) 732-5959

495 N 13TH St
Newark, NJ 07107-1317
Phone (973) 732-5959

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA01905200NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Holsman Physical and Occupational Therapy, PC CurrentSince Dec 9, 2019 Accepting new patients
Holsman Physical and Occupational Therapy PC Physical Therapist CurrentSince Dec 9, 2019 Accepting new patients
Elite PT LLC Physical Therapist CurrentSince May 1, 2023 Accepting new patients
Elite Physical Therapy LLC Physical Therapist CurrentSince Sep 1, 2021 Accepting new patients

Locations

1070 Clifton Ave
Ste 1A
Clifton, NJ 07013
Phone (973) 246-6565

15-01 Broadway
Ste 12
Fair Lawn, NJ 07410
Phone (201) 355-5199

711 Kearny Ave
#2
Kearny, NJ 07032
Phone (201) 535-8555

198 Market St
#208
Newark, NJ 07102
Phone (973) 732-5959

495 N 13th St
Newark, NJ 07107
Phone (973) 268-1400

1600 Saint Georges Ave
Ste 107
Rahway, NJ 07065
Phone (732) 428-5566

Organizations & group practices 4

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": "1575331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575331200000",
    "number": "1700423241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 MOUNT PROSPECT AVE APT 1A",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071042128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 N 5TH ST # C104",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071074804",
            "telephone_number": "973-910-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCPHERSON",
        "first_name": "ANTHONY",
        "middle_name": "AUBREY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-12-03",
        "last_updated": "2019-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01905200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 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.