Individual provider Active NPI

David Guerrier, PTA

  • Physical Therapy Assistant
  • Jersey City, NJ
National Provider Identifier
1831706845
Registry record updated Sep 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
40QB00224700 Issued in NJ
Practice address
537 Pavonia Ave
Jersey City, NJ 07306-1803
Phone
(973) 744-5518
NPI assigned
Sep 24, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 40QB00224700 NJ Primary

Addresses

Primary practice location

537 Pavonia Ave
Jersey City, NJ 07306-1803

Mailing address

51 Oak St Apt 1
East Orange, NJ 07018-2881
Phone (862) 215-9077

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

LicenseStateTypeSpecialty
40QB00224700NJMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Willow Creek Rehabilitation PastSince Sep 27, 2020 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1600905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600905600000",
    "number": "1831706845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 OAK ST APT 1",
            "city": "EAST ORANGE",
            "state": "NJ",
            "postal_code": "070182881",
            "telephone_number": "862-215-9077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "537 PAVONIA AVE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073061803",
            "telephone_number": "973-744-5518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUERRIER",
        "first_name": "DAVID",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-24",
        "last_updated": "2020-09-24",
        "certification_date": "2020-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NJ",
            "license": "40QB00224700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jersey City, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.