Active NPI
Kenneth Gerard Grieco, PT
- Physical Therapist
- Rockaway, NJ
National Provider Identifier
1760633374
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 40QA00524800
- Practice address
- 172 Chestnut Ter
Rockaway, NJ 07866-2411 - Phone
- (201) 602-6939
- NPI assigned
- Oct 2, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 40QA00524800 | NJ | Primary |
Addresses
Primary practice location
172 Chestnut Ter
Rockaway, NJ 07866-2411
Mailing address
172 Chestnut Ter
Rockaway, NJ 07866-2411
Phone (201) 602-6939
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40QA00524800 | NJ | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| At Home Physical Therapy, LLC | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Physical Therapist
- Morris Plains, NJ
- NPI 1861609059
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1222905600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1222905600000",
"number": "1760633374",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "172 CHESTNUT TER",
"city": "ROCKAWAY",
"state": "NJ",
"postal_code": "078662411",
"telephone_number": "201-602-6939"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "172 CHESTNUT TER",
"city": "ROCKAWAY",
"state": "NJ",
"postal_code": "078662411",
"telephone_number": "201-602-6939"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRIECO",
"first_name": "KENNETH",
"middle_name": "GERARD",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-10-02",
"last_updated": "2008-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NJ",
"license": "40QA00524800",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rockaway, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.