Individual provider Active NPI

Kenneth Simms, DPT

  • Physical Therapist
  • Cedar Knolls, NJ
National Provider Identifier
1740615079
Registry record updated Sep 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA0151730 Issued in NJ
Practice address
197 Ridgedale Ave Suite 155
Cedar Knolls, NJ 07927
Phone
(973) 605-5115
Fax
(973) 605-5995
NPI assigned
Sep 5, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2013

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 40QA0151730 NJ Primary

Addresses

Primary practice location

197 Ridgedale Ave Suite 155
Cedar Knolls, NJ 07927

Mailing address

11 Eagle Rock Ave
East Hanover, NJ 07936
Phone (973) 887-9000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131030000369 NJ Practitioner - Physical Therapist in Private Practice 1355576398 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sportscare of America, PCGroup PAC ID 9032213756, 132 clinicians

Practice addresses (Care Compare)

111 W Water St
Toms River, NJ 08753-6407
Phone (732) 473-9400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA0151730NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
United Sports Care & Physical Therapy Physical Therapist CurrentSince Sep 1, 2016 Accepting new patients
K Simms Physical Therapy Physical Therapist Current Accepting new patients
Diagnostix Physical Therapy and Rehabilitation Physical Therapist CurrentSince Aug 1, 2023 Accepting new patients
Sportscare of America, PC Physical Therapist CurrentSince Sep 3, 2013 Accepting new patients
Sportscare Institute, Inc. Physical Therapist Past Accepting new patients

Locations

47 S Washington Ave
Bergenfield, NJ 07621
Phone (201) 384-2525

1161 Burnt Tavern Rd
Brick, NJ 08724
Phone (732) 458-1255

197 Ridgedale Ave
Cedar Knolls, NJ 07927
Phone (973) 292-0700

197 Ridgedale Ave
Ste 155
Cedar Knolls, NJ 07927
Phone (973) 605-5115

11 Eagle Rock Ave
Fl 2
East Hanover, NJ 07936
Phone (973) 887-3000

609 Morris Ave
Ste 2
Springfield, NJ 07081
Phone (973) 671-3200

111 W Water St
Toms River, NJ 08753
Phone (732) 473-9440

Organizations & group practices 5

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": "1378339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378339200000",
    "number": "1740615079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 EAGLE ROCK AVE",
            "city": "EAST HANOVER",
            "state": "NJ",
            "postal_code": "07936",
            "telephone_number": "973-887-9000",
            "fax_number": "973-887-3816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "197 RIDGEDALE AVE SUITE 155",
            "city": "CEDAR KNOLLS",
            "state": "NJ",
            "postal_code": "07927",
            "telephone_number": "973-605-5115",
            "fax_number": "973-605-5995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMS",
        "first_name": "KENNETH",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-05",
        "last_updated": "2013-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA0151730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Knolls, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2013; 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.