Vsevolod Elkanovich, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA01095600 Issued in NJ

Practice address

765 Newman Springs Rd
Lincroft, NJ 07738-1543

Phone

(732) 370-4855

Fax

(732) 344-4484

NPI assigned

Jul 15, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Shore Regional Home TherapiesGroup PAC ID 0547621658, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Shore Regional Home Therapies

  • Physical Therapist
  • Cliffwood, NJ
  • NPI 1255029898
  Medicare reassignment Care Compare group NPD
• Mobile Therapy Services, Inc.

  • Physical Therapist
  • Ocean, NJ
  • NPI 1326495615
  Medicare reassignment NPD
• Romtherapy New Jersey Medical PA

  • Cardiovascular Disease Physician
  • Trenton, NJ
  • NPI 1568227262
  Medicare reassignment NPD
• Romtherapy Connecticut Medical PC

  • Cardiovascular Disease Physician
  • Waterbury, CT
  • NPI 1750146452

  NJ

  Medicare reassignment NPD
• Spectrum Physical Rehabilitation & Therapy , LLC

  • Rehabilitation Chiropractor
  • Jackson, NJ
  • NPI 1447309299
  NPD (past)
• Romtherapy Inc

  • Cardiovascular Disease Physician
  • Brookfield, CT
  • NPI 1285380360

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1121385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572566400000",
    "number": "1801895446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "765 NEWMAN SPRINGS RD",
            "city": "LINCROFT",
            "state": "NJ",
            "postal_code": "077381543",
            "telephone_number": "732-370-4855",
            "fax_number": "732-344-4484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "765 NEWMAN SPRINGS RD",
            "city": "LINCROFT",
            "state": "NJ",
            "postal_code": "077381543",
            "telephone_number": "732-370-4855",
            "fax_number": "732-344-4484"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4695 US Highway 9",
            "address_purpose": "LOCATION",
            "city": "Howell",
            "state": "NJ",
            "postal_code": "077313384",
            "country_code": "US",
            "telephone_number": "732-370-4855",
            "fax_number": "732-370-4880",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELKANOVICH",
        "first_name": "VSEVOLOD",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-15",
        "last_updated": "2019-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01095600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "732-370-4855",
            "affiliation": "N",
            "address_1": "765 Newman Springs Rd",
            "city": "Lincroft",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "077381543",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Physical Therapist in Lincroft, NJ
• Providers in Lincroft, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.