Individual provider Active NPI

Richard L Dawkins Jr, PT

  • Physical Therapist
  • Brick, NJ
National Provider Identifier
1700945219
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA00671000 Issued in NJ
Practice address
990 Cedarbridge Ave
B-16
Brick, NJ 08723-4159
Phone
(732) 262-0111
Fax
(732) 262-0332
NPI assigned
Dec 8, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 40QA00671000 NJ Primary

Addresses

Primary practice location

990 Cedarbridge Ave
B-16
Brick, NJ 08723-4159

Mailing address

990 Cedarbridge Ave
B-16
Brick, NJ 08723-4159
Phone (732) 262-0111

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110118000542 NJ Practitioner - Physical Therapist in Private Practice 3375670128 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

990 Cedar Bridge Ave
Suite B16
Brick, NJ 08723-4158
Phone (732) 262-0111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA00671000NJMDPhysical Therapist

Organizations & group practices 1

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": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700945219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "990 CEDARBRIDGE AVE",
            "address_2": "B-16",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087234159",
            "telephone_number": "732-262-0111",
            "fax_number": "732-262-0332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "990 CEDARBRIDGE AVE",
            "address_2": "B-16",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087234159",
            "telephone_number": "732-262-0111",
            "fax_number": "732-262-0332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAWKINS JR",
        "first_name": "RICHARD",
        "middle_name": "L",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA00671000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brick, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.