NPIMap

Organization Active NPI

Garden State Physical Therapy Group PC

  • Physical Therapy Clinic/Center
  • Freehold, NJ
National Provider Identifier
1801274022
Registry record updated Sep 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
40QA01465600 Issued in NJ
Legal business name
GARDEN STATE PHYSICAL THERAPY GROUP PC
Practice address
55-77 Schanck Rd Ste B-17
Freehold, NJ 07728-2964
Phone
(732) 414-6060
NPI assigned
May 7, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2020

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

Authorized official

Name
Dr. Noah Seth Miller, D.P.T.NPI 1700136389
Title
Physical Therapist
Phone
(908) 415-5414

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 40QA01465600 NJ Primary

Addresses

Primary practice location

55-77 Schanck Rd Ste B-17
Freehold, NJ 07728-2964

Mailing address

55-77 Schanck Rd Ste B-17
Freehold, NJ 07728-2964
Phone (732) 414-6060

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20151006000478 NJ Part B Supplier - Physical/Occupational Therapy Group in Private Practice 8426366741 Receives reassigned benefits from 22 practitioners
Practice locations: Colonia, NJ; Freehold, NJ
O20200902003011 NJ DME Supplier - Independently-Practicing Physical Therapist 8426366741 Practice locations: Freehold, NJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 24

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

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1430956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598918400000",
    "number": "1801274022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55-77 SCHANCK RD STE B-17",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077282964",
            "telephone_number": "732-414-6060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55-77 SCHANCK RD STE B-17",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077282964",
            "telephone_number": "732-414-6060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARDEN STATE PHYSICAL THERAPY GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-07",
        "last_updated": "2020-09-01",
        "certification_date": "2020-08-11",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "NOAH",
        "authorized_official_middle_name": "SETH",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "908-415-5414",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.T."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NJ",
            "license": "40QA01465600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Freehold, NJ

Sources for this page

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