Individual provider Active NPI

Jayson Iporac Ceribo, PT

  • Physical Therapist
  • East Brunswick, NJ
National Provider Identifier
1841345329
Registry record updated Jul 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01094600 Issued in NJ
Practice address
150A Tices LN
East Brunswick, NJ 08816-2015
Phone
(732) 254-5553
NPI assigned
Jan 24, 2007
Last updated
Jul 29, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 40QA01094600 NJ Primary

Addresses

Primary practice location

150A Tices LN
East Brunswick, NJ 08816-2015

Mailing address

124 Alden St
Wallington, NJ 07057-1434
Phone (732) 299-0973

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041105000233 NJ Practitioner - Physical Therapist in Private Practice 3476516048 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

301 Hoboken Rd
Suite 1
Carlstadt, NJ 07072-1044
Phone (201) 804-1000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA01094600NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Enjoy Jersey Services LLC Physical Therapist CurrentSince Nov 17, 2024 Accepting new patients
Jel Physical Therapy, PC Physical Therapist CurrentSince Jul 27, 2020 Accepting new patients
Allcare Medical and Pain Management Group PA Past Accepting new patients

Locations

305 Bayonne Crossing Way
Bayonne, NJ 07002
Phone (201) 778-2020

301 Hoboken Rd
Ste 1
Carlstadt, NJ 07072
Phone (201) 804-1000

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564358400000",
    "number": "1841345329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 ALDEN ST",
            "city": "WALLINGTON",
            "state": "NJ",
            "postal_code": "070571434",
            "telephone_number": "732-299-0973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150A TICES LN",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088162015",
            "telephone_number": "732-254-5553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CERIBO",
        "first_name": "JAYSON",
        "middle_name": "IPORAC",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-24",
        "last_updated": "2019-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01094600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Brunswick, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 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.