Kenneth A Guzzardo, PT, DPT, OCS

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

40QA01251600 Issued in NJ

Practice address

200 Tuckerton Rd
Ste 17
Medford, NJ 08055-8806

Phone

(856) 396-2250

Fax

(856) 810-0373

NPI assigned

Jul 11, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Jefferson Medical College of Thomas Jefferson University, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ipta Clinical, LLCGroup PAC ID 0749456119, 126 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Ipta Clinical, LLC

  • Physical Therapy Clinic/Center
  • Medford, NJ
  • NPI 1760764484

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• 3 Dimensional Physical Therapy - Pelvic Health LLC

  • Physical Therapist
  • Medford, NJ
  • NPI 1275348500
  NPD

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

{
    "created_epoch": "1184112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314576000000",
    "number": "1730387739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 TUCKERTON RD",
            "address_2": "STE 17",
            "city": "MEDFORD",
            "state": "NJ",
            "postal_code": "080558806",
            "telephone_number": "856-396-2250",
            "fax_number": "856-810-0373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 TUCKERTON RD",
            "address_2": "STE 17",
            "city": "MEDFORD",
            "state": "NJ",
            "postal_code": "080558806",
            "telephone_number": "856-396-2250",
            "fax_number": "856-810-0373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUZZARDO",
        "first_name": "KENNETH",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "PT, DPT, OCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-11",
        "last_updated": "2011-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PTO017218L",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT017218",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NJ",
            "license": "40QA01251600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph John Grosso, LPC, ATR
• Carla Y. Grovatt, PA-C
• Stephanie Guido, DO
• Jessica Anne Marie Gunn, A.P.N
• Gabriella Gutman, MD
• Alyssa Haines
• Carl J Hajduk, DDS
• Stephen James Hak, RPH
• Ashanti Hameed
• Hammonton Orthopedic and Sports Physical Therapy (Atlantic Orthopedic and Sports Physical Therapy)

• Orthopedic Physical Therapist in Medford, NJ
• Providers in Medford, NJ by specialty
• Orthopedic Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2011; 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.