Individual provider Active NPI

Jet Adam Gaminde VIII, P.T.

  • Geriatric Physical Therapist
  • Clifton, NJ
National Provider Identifier
1720334147
Registry record updated Jul 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Physical TherapistTaxonomy code 2251G0304X
License
40QA01401100 Issued in NJ
Practice address
1070 Clifton Ave
Suite 1a
Clifton, NJ 07013-3619
Phone
(973) 246-6565
NPI assigned
Aug 3, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Physical Therapist 2251G0304X 40QA01401100 NJ Primary

Addresses

Primary practice location

1070 Clifton Ave
Suite 1a
Clifton, NJ 07013-3619

Mailing address

89 Franklin Ave
Apt 3
West Orange, NJ 07052-6047
Phone (786) 380-6803

Other names 1

  • Mr. Epifanio Ramos Gaminde Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121126000427 NJ Practitioner - Physical Therapist in Private Practice 1355592353 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
Specialty Medconsultants LLCGroup PAC ID 3072736677, 20 clinicians

Practice addresses (Care Compare)

6725 Ventnor Ave
Suite C
Ventnor City, NJ 08406-2166
Phone (609) 350-6780

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA01401100NJMDGeriatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Jag-One Physical Therapy, LLC Geriatrics CurrentSince May 15, 2024 Accepting new patients
Specialty Medconsultants LLC CurrentSince May 1, 2025 Accepting new patients
Holsman Physical and Occupational Therapy PC PastSince Aug 1, 2012 Accepting new patients

Locations

981 US Highway 22
Fl 2
Bridgewater, NJ 08807
Phone (908) 231-0511

3860 Bayshore Rd
Ste F
North Cape May, NJ 08204
Phone (609) 525-4510

331 Tilton Rd
Ste 2A
Northfield, NJ 08225
Phone (609) 383-3313

221 Rockingham Row
Princeton, NJ 08540
Phone (609) 580-1520

6725 Ventnor Ave
Ste C
Ventnor City, NJ 08406
Phone (609) 350-6780

622 Eagle Rock Ave
West Orange, NJ 07052
Phone (973) 669-0078

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": "1343952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688342400000",
    "number": "1720334147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "89 FRANKLIN AVE",
            "address_2": "APT 3",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070526047",
            "telephone_number": "786-380-6803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1070 CLIFTON AVE",
            "address_2": "SUITE 1A",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070133619",
            "telephone_number": "973-246-6565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMINDE",
        "first_name": "JET",
        "middle_name": "ADAM",
        "name_prefix": "Mr.",
        "name_suffix": "VIII",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-03",
        "last_updated": "2023-07-03",
        "certification_date": "2023-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "NJ",
            "license": "40QA01401100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EPIFANIO",
            "last_name": "GAMINDE",
            "middle_name": "RAMOS",
            "prefix": "MR.",
            "credential": "P.T.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Clifton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2023; 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.