NPIMap

Organization Active NPI

Rehability Sports Medicine, LLC

  • Physical Medicine & Rehabilitation Physician
  • Freehold, NJ
National Provider Identifier
1851935837
Registry record updated Nov 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
REHABILITY SPORTS MEDICINE, LLC
Practice address
83 South St. Ste 204
Freehold, NJ 07728
Phone
(732) 780-6230
Fax
(732) 780-6232
NPI assigned
Nov 1, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2019

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

Authorized official

Name
Dr. Joseph Jimenez, MDNPI 1437310448
Title
Authorized Representative
Phone
(732) 780-6230

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X
AcupuncturistGroup: 193200000X MULTI-SPECIALTY GROUP 171100000X
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X Primary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X

Addresses

Primary practice location

83 South St. Ste 204
Freehold, NJ 07728

Mailing address

83 South St. Ste 204
Freehold, NJ 07728
Phone (732) 780-6230

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200107002339 NJ Part B Supplier - Clinic/Group Practice 8426482076 Receives reassigned benefits from 1 practitioner
Practice locations: Freehold, NJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 12

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

NPI Registry JSON

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

{
    "created_epoch": "1572566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572566400000",
    "number": "1851935837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "83 SOUTH ST. STE 204",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "07728",
            "telephone_number": "732-780-6230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "83 SOUTH ST. STE 204",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "07728",
            "telephone_number": "732-780-6230",
            "fax_number": "732-780-6232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REHABILITY SPORTS MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-01",
        "last_updated": "2019-11-01",
        "status": "A",
        "authorized_official_last_name": "JIMENEZ",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "AUTHORIZED REPRESENTATIVE",
        "authorized_official_telephone_number": "732-780-6230",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.