Individual provider Active NPI

Jennifer Liss, PT

  • Physical Therapist
  • Sewell, NJ
National Provider Identifier
1750589933
Registry record updated May 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA00800000 Issued in NJ
Practice address
14 Parke Place Blvd
Suite D
Sewell, NJ 08080-2661
Phone
(856) 256-8393
Fax
(856) 256-8390
NPI assigned
Jul 10, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2016

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 40QA00800000 NJ Primary

Addresses

Primary practice location

14 Parke Place Blvd
Suite D
Sewell, NJ 08080-2661

Mailing address

14 Parke Place Blvd
Suite D
Sewell, NJ 08080-2661
Phone (856) 256-8393

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041113000058 NJ Practitioner - Physical Therapist in Private Practice 2264496835 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Temple University School of Medicine, 1998
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)

14 Parke Place Blvd
Suite D
Sewell, NJ 08080-2662
Phone (856) 256-8393

175 Route 70
Suite 19
Medford, NJ 08055-2355
Phone (609) 714-3378

3104 Bridgeboro Rd
Suite B
Delran, NJ 08075-9716
Phone (856) 460-6424

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA00800000NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ipta Clinical, LLC Physical Therapist CurrentSince Mar 1, 2025 Accepting new patients
Therasport Physical Therapy, LLC Physical Therapist CurrentSince Sep 1, 2013 Accepting new patients
Cross Keys Physical Therapy Sports Medical Center, Inc Physical Therapist PastSince Aug 1, 2002 Accepting new patients
Atlantic Orthopedic & Sports Physical Therapy PC Physical Therapist PastSince Jun 15, 2012 Accepting new patients
3 Dimensional Physical Therapy - Pelvic Health LLC Physical Therapist PastSince Feb 23, 2025 Accepting new patients

Locations

175 Route 70
Ste 19
Medford, NJ 08055
Phone (609) 257-3750

30 W Maple Ave
Merchantville, NJ 08109
Phone (856) 661-0200

14 Parke Place Blvd
Ste D
Sewell, NJ 08080
Phone (856) 256-8393

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": "1184025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463443200000",
    "number": "1750589933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 PARKE PLACE BLVD",
            "address_2": "SUITE D",
            "city": "SEWELL",
            "state": "NJ",
            "postal_code": "080802661",
            "telephone_number": "856-256-8393",
            "fax_number": "856-256-8390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 PARKE PLACE BLVD",
            "address_2": "SUITE D",
            "city": "SEWELL",
            "state": "NJ",
            "postal_code": "080802661",
            "telephone_number": "856-256-8393",
            "fax_number": "856-256-8390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISS",
        "first_name": "JENNIFER",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-10",
        "last_updated": "2016-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA00800000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sewell, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2016; 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.