NPIMap

Organization Active NPI

Herrick Home Care Physical Therapy Orthopedic & Pediatric Services PC

  • Orthopedic Physical Therapist
  • Wayne, NJ
National Provider Identifier
1750861365
Registry record updated Dec 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
40QA01562000 Issued in NJ
Legal business name
HERRICK HOME CARE PHYSICAL THERAPY ORTHOPEDIC & PEDIATRIC SERVICES PC
Practice address
2282 Hamburg Tpke Ste a
Wayne, NJ 07470-6291
Phone
(973) 800-4050
Fax
(862) 330-3186
NPI assigned
Aug 14, 2018
Last updated
Dec 1, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2020

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

Authorized official

Name
Dr. Kyle David Herrick, PT, DPTNPI 1972995454
Title
Owner
Phone
(973) 800-4050

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2251X0800X 40QA01562000 NJ Primary
Speech-Language PathologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 235Z00000X 41YS00937900 NJ

Addresses

Primary practice location

2282 Hamburg Tpke Ste a
Wayne, NJ 07470-6291

Mailing address

2282 Hamburg Tpke Ste a
Wayne, NJ 07470-6291
Phone (973) 800-4050

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL herrickphysicaltherapy.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180905003345 NJ Part B Supplier - Clinic/Group Practice 8325398712 Receives reassigned benefits from 4 practitioners
Practice locations: Wayne, NJ

National Provider Directory

National Provider Directory

Locations

2282 Hamburg Tpke
Ste A
Wayne, NJ 07470
Phone (973) 800-4050

Practitioners & affiliated clinicians

Practitioners 7

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": "1534204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606780800000",
    "number": "1750861365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2282 HAMBURG TPKE STE A",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074706291",
            "telephone_number": "973-800-4050",
            "fax_number": "862-330-3186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2282 HAMBURG TPKE STE A",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074706291",
            "telephone_number": "973-800-4050",
            "fax_number": "862-330-3186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERRICK HOME CARE PHYSICAL THERAPY ORTHOPEDIC & PEDIATRIC SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-14",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A",
        "authorized_official_last_name": "HERRICK",
        "authorized_official_first_name": "KYLE",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-800-4050",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NJ",
            "license": "40QA01562000",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "NJ",
            "license": "41YS00937900",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "herrickphysicaltherapy.com",
            "affiliation": "N",
            "address_1": "2282 Hamburg Tpke Ste A",
            "city": "Wayne",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "074706291",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wayne, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2020; 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.