Individual provider Active NPI

Jonathan Gu

  • Physical Therapist
  • Secaucus, NJ
National Provider Identifier
1700614799
Registry record updated Jul 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
150 Flanagan Way
Secaucus, NJ 07094-3445
Phone
(201) 319-0010
Fax
(201) 319-8994
NPI assigned
Jul 23, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2024

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 NJ Primary

Addresses

Primary practice location

150 Flanagan Way
Secaucus, NJ 07094-3445

Mailing address

576 Broadhollow Rd
Melville, NY 11747-5002

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240926002040 NJ Practitioner - Physical Therapist in Private Practice 8729529094 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

150 Flanagan Way
Secaucus, NJ 07094-3445
Phone (201) 319-0010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist Current Accepting new patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist CurrentSince Sep 3, 2024 Accepting new patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist CurrentSince Sep 3, 2024 Accepting new patients

Locations

70 Ridge Rd
Lyndhurst, NJ 07071
Phone (201) 933-4775

1 Greenwood Ave
Montclair, NJ 07042
Phone (973) 746-2424

150 Flanagan Way
Secaucus, NJ 07094
Phone (201) 319-0010

524 Williamstown Rd
Ste B1
Sicklerville, NJ 08081
Phone (856) 516-0591

576 Broadhollow Rd
Melville, NY 11747

Organizations & group practices 3

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": "1721692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1700614799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "576 BROADHOLLOW RD",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117475002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 FLANAGAN WAY",
            "city": "SECAUCUS",
            "state": "NJ",
            "postal_code": "070943445",
            "telephone_number": "201-319-0010",
            "fax_number": "201-319-8994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GU",
        "first_name": "JONATHAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-07-23",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Secaucus, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2024; 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.