NPIMap

Organization Active NPI

Trinity Rehab Somerset PA

  • Physical Therapist
  • Clark, NJ
National Provider Identifier
1760957294
Registry record updated Oct 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
TRINITY REHAB SOMERSET PA
Practice address
301 Central Ave Ste 101
Clark, NJ 07066-1107
Phone
(848) 666-1818
NPI assigned
Oct 11, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2018

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

Authorized official

Name
Tonya Gavrielides
Title
Director of Operations
Phone
(732) 219-5700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

301 Central Ave Ste 101
Clark, NJ 07066-1107

Mailing address

554-558 Highway 35
Red Bank, NJ 07701-5038
Phone (732) 219-5700

Other names 1

  • Trinity Rehab Clark Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170113000019 NJ Part B Supplier - Physical/Occupational Therapy Group in Private Practice 0547540809 Receives reassigned benefits from 136 practitioners
37 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Piscataway, NJ; Morristown, NJ; Red Bank, NJ; Sewell, NJ; Short Hills, NJ; Shrewsbury, NJ; Somers Point, NJ; Somerset, NJ…

Other NPIs on the same Medicare enrollment 37

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 37

National Provider Directory

National Provider Directory
Tax ID family
Trinity Rehab Somerset PA34 organizations share this tax ID, including this one

Other organizations with this tax ID 33

Organizations that report the same tax identification number in the National Provider Directory.

View all 33

Locations

301 Central Ave
Ste 101
Clark, NJ 07066
Phone (848) 666-1818

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1539216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539216000000",
    "number": "1760957294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "554-558 HIGHWAY 35",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077015038",
            "telephone_number": "732-219-5700",
            "fax_number": "732-334-3005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 CENTRAL AVE STE 101",
            "city": "CLARK",
            "state": "NJ",
            "postal_code": "070661107",
            "telephone_number": "848-666-1818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRINITY REHAB SOMERSET PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-11",
        "last_updated": "2018-10-11",
        "status": "A",
        "authorized_official_last_name": "GAVRIELIDES",
        "authorized_official_first_name": "TONYA",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "732-219-5700"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Trinity Rehab Clark",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clark, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2018; 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.