Organization Active NPI

Ipta Clinical, LLC

  • Physical Therapy Clinic/Center
  • Medford, NJ
National Provider Identifier
1760764484
Registry record updated Jun 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
IPTA CLINICAL, LLC
Practice address
175 Route 70
Suite 19
Medford, NJ 08055-2300
Phone
(609) 714-3378
Fax
(856) 583-6004
NPI assigned
Sep 20, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2021

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

Authorized official

Name
Jeanine Doherty
Title
Operations Manager
Phone
(609) 257-3750

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

175 Route 70
Suite 19
Medford, NJ 08055-2300

Mailing address

175 Route 70
Suite 19
Medford, NJ 08055-2300
Phone (609) 714-3378

Other names 1

  • 3 Dimensional Physical Therapy Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, PA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20120106000040 NJ Part B Supplier - Physical/Occupational Therapy Group in Private Practice 0749456119 Receives reassigned benefits from 145 practitioners
Practice locations: Hainesport, NJ; Jersey City, NJ; Kendall Park, NJ; Lebanon, NJ; Medford, NJ; Merchantville, NJ; Oceanport, NJ; Old Tappan, NJ…
O20250815000903 PA Part B Supplier - Clinic/Group Practice 0749456119 Receives reassigned benefits from 3 practitioners
Practice locations: Jenkintown, PA; Philadelphia, PA
O20250925000584 NJ DME Supplier - Independently-Practicing Physical TherapistDME Supplier - Independently-Practicing Occupational Therapist 0749456119 Practice locations: Cherry Hill, NJ

National Provider Directory

National Provider Directory

Locations (25 of 27)

646 Plaza Dr
Unit 1214
Newark, DE 19702

112 Haddontowne Ct
Ste 303
Cherry Hill, NJ 08034
Phone (856) 354-5044

2103 Branch Pike
Ste 2
Cinnaminson, NJ 08077
Phone (609) 634-0091

1500 Almonesson Rd
Ste 7
Deptford, NJ 08096
Phone (856) 352-0621

1500 Almonesson Rd
Ste 3
Deptford, NJ 08096
Phone (856) 352-0621

180 Tices Ln
Ste 101
East Brunswick, NJ 08816
Phone (732) 418-7033

2205 Delsea Dr
Ste 6
Franklinville, NJ 08322

311 S New York Rd
Ste 22
Galloway, NJ 08205
Phone (609) 300-3963

311 S New York Rd
Ste 1A
Galloway, NJ 08205

413 W Crystal Lake Ave
Unit 8
Haddonfield, NJ 08033
Phone (856) 240-7609

413 W Crystal Lake Ave
Unit 9
Haddonfield, NJ 08033

1509 Route 38
Ste 89
Hainesport, NJ 08036
Phone (609) 784-8426

1509 Route 38
#38
Hainesport, NJ 08036

1271 US Highway 22
Ste 19
Lebanon, NJ 08833
Phone (908) 257-0602

1271 US Highway 22
Ste N7
Lebanon, NJ 08833

23 S Main St
Ste 2
Medford, NJ 08055

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

175 Route 70
Medford, NJ 08055
Phone (609) 953-7692

1000 Sanger Ave
Ste 125
Oceanport, NJ 07757
Phone (732) 255-7404

1000 Sanger Ave
Oceanport, NJ 07757
Phone (732) 687-2418

15 Roszel Rd
Ste 107
Princeton, NJ 08540
Phone (609) 250-2850

1572 Route 206
Ste 4
Tabernacle, NJ 08088
Phone (609) 257-3750

115 N Route 73
Unit 80
West Berlin, NJ 08091
Phone (856) 335-4938

1155 S Black Horse Pike
Ste B
Williamstown, NJ 08094
Phone (856) 335-4938

261 Old York Rd
Ste 204
Jenkintown, PA 19046
Phone (267) 616-9227

Practitioners & affiliated clinicians

Practitioners 201

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 201

NPI Registry JSON

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

{
    "created_epoch": "1316476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622505600000",
    "number": "1760764484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 ROUTE 70",
            "address_2": "SUITE 19",
            "city": "MEDFORD",
            "state": "NJ",
            "postal_code": "080552300",
            "telephone_number": "609-714-3378",
            "fax_number": "856-583-6004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 ROUTE 70",
            "address_2": "SUITE 19",
            "city": "MEDFORD",
            "state": "NJ",
            "postal_code": "080552300",
            "telephone_number": "609-714-3378",
            "fax_number": "856-583-6004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IPTA CLINICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-20",
        "last_updated": "2021-06-01",
        "certification_date": "2021-06-01",
        "status": "A",
        "authorized_official_last_name": "DOHERTY",
        "authorized_official_first_name": "JEANINE",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "609-257-3750"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "3 Dimensional Physical Therapy",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Medford, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2021; 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.