Individual provider Active NPI

Jeremy B Breden, PT

  • Physical Therapist
  • Glen Burnie, MD
National Provider Identifier
1700918943
Registry record updated Jul 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
19718 Issued in MD
Practice address
1406B Crain Hwy S
Suite 107
Glen Burnie, MD 21061-4099
Phone
(410) 590-2334
Fax
(410) 590-2336
NPI assigned
Mar 12, 2007
Last updated
Jul 26, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2018

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 19718 MD Primary

Addresses

Primary practice location

1406B Crain Hwy S
Suite 107
Glen Burnie, MD 21061-4099

Mailing address

1377 Motor Pkwy
Ste 307
Islandia, NY 11749-5258
Phone (631) 580-5200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180820002088 NJ Practitioner - Physical Therapist in Private Practice 4385790294 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atlantic Physical Therapy CenterGroup PAC ID 8820168123, 117 clinicians

Practice addresses (Care Compare)

3 Paragon Way
Suite 250
Freehold, NJ 07728-9578
Phone (732) 431-2883

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ivyrehab Network Inc. Physical Therapist Current Accepting new patients
Atlantic Physical Therapy Center CurrentSince Jan 29, 2019 Accepting new patients
Ivyrehab Network, Inc. Physical Therapist CurrentSince Aug 6, 2018 Accepting new patients
Atlantic Physical Therapy Center Physical Therapist CurrentSince Jan 29, 2019 Accepting new patients
Ivyrehab Network Inc Physical Therapist CurrentSince Aug 6, 2018 Accepting new patients
Atlantic Physical Therapy Center Past Accepting new patients
Seashore Pediatric Therapy Center PC Past Accepting new patients
Esterson Physical Therapy PA Physical Therapist PastSince Aug 1, 2002 Accepting new patients
Esterson and Associates, P.C. Physical Therapist Past Accepting new patients

Locations

731 Lacey Rd
Ste 3
Forked River, NJ 08731
Phone (609) 242-6780

3 Paragon Way
Ste 250
Freehold, NJ 07728
Phone (732) 431-2883

285 Gordons Corner Rd
Ste 2
Manalapan, NJ 07726
Phone (848) 884-3400

1037 Route 70
Manchester, NJ 08759
Phone (732) 408-1800

1500 Meeting House Rd
Sea Girt, NJ 08750
Phone (732) 722-8787

1377 Motor Pkwy
Ste 307
Ronkonkoma, NY 11749

Organizations & group practices 9

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": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532563200000",
    "number": "1700918943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1377 MOTOR PKWY",
            "address_2": "STE 307",
            "city": "ISLANDIA",
            "state": "NY",
            "postal_code": "117495258",
            "telephone_number": "631-580-5200",
            "fax_number": "631-580-5222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1406B CRAIN HWY S",
            "address_2": "SUITE 107",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210614099",
            "telephone_number": "410-590-2334",
            "fax_number": "410-590-2336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREDEN",
        "first_name": "JEREMY",
        "middle_name": "B",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-12",
        "last_updated": "2018-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "19718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Burnie, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2018; 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.