Organization Active NPI

Jersey Physical Therapy of Milltown/East Brunswick

  • Physical Therapist
  • East Brunswick, NJ
National Provider Identifier
1730138512
Registry record updated Mar 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
JERSEY PHYSICAL THERAPY OF MILLTOWN/EAST BRUNSWICK
Practice address
180 Tices LN
East Brunswick, NJ 08816-1337
Phone
(732) 418-7033
Fax
(732) 418-7011
NPI assigned
May 9, 2006
Last updated
Mar 3, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2014

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

Authorized official

Name
Sean T. Moore, PT, MPTNPI 1215985585
Title
Managing Member
Phone
(732) 418-7033

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary

Addresses

Primary practice location

180 Tices LN
East Brunswick, NJ 08816-1337

Mailing address

3228 State Route 27
Kendall Park, NJ 08824-1524
Phone (732) 297-0032

Other identifiers 1

IdentifierTypeStateIssuer
7074461OtherNJAETNA PROVIDER NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060905000206 NJ Part B Supplier - Physical/Occupational Therapy Group in Private Practice 1254335300 Receives reassigned benefits from 11 practitioners
Practice locations: East Brunswick, NJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393804800000",
    "number": "1730138512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3228 STATE ROUTE 27",
            "city": "KENDALL PARK",
            "state": "NJ",
            "postal_code": "088241524",
            "telephone_number": "732-297-0032",
            "fax_number": "732-418-7011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 TICES LN",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088161337",
            "telephone_number": "732-418-7033",
            "fax_number": "732-418-7011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERSEY PHYSICAL THERAPY OF MILLTOWN/EAST BRUNSWICK",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-09",
        "last_updated": "2014-03-03",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "SEAN",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "732-418-7033",
        "authorized_official_credential": "PT, MPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER NUMBER",
            "identifier": "7074461",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Brunswick, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.