Active NPI
Jaime Luis Nieves Jr., P.T.A.
- Physical Therapy Assistant
- Keansburg, NJ
National Provider Identifier
1780883199
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 40 QB00191000
- Practice address
- 32 Laurel Ave
Keansburg, NJ 07734-1125 - Phone
- (732) 787-8100
- NPI assigned
- Jul 16, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 Therapy Assistant | 225200000X | 40 QB00191000 | NJ | Primary |
Addresses
Primary practice location
32 Laurel Ave
Keansburg, NJ 07734-1125
Mailing address
1123B Hollywood Rd
Linden, NJ 07036-5629
Phone (908) 531-9224
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40 QB00191000 | NJ | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184544000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184544000000",
"number": "1780883199",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1123B HOLLYWOOD RD",
"city": "LINDEN",
"state": "NJ",
"postal_code": "070365629",
"telephone_number": "908-531-9224"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "32 LAUREL AVE",
"city": "KEANSBURG",
"state": "NJ",
"postal_code": "077341125",
"telephone_number": "732-787-8100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NIEVES",
"first_name": "JAIME",
"middle_name": "LUIS",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "P.T.A.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-07-16",
"last_updated": "2007-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "NJ",
"license": "40 QB00191000",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Keansburg, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.