Individual provider Active NPI

Anna S Palkin, D.P.T.

  • Physical Therapist
  • Hackensack, NJ
National Provider Identifier
1891719431
Registry record updated Oct 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
QA01266400 Issued in NJ
Practice address
605 Main Street
Hackensack, NJ 07601
Phone
(201) 488-0488
NPI assigned
Jul 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 024599-1 NY
Physical Therapist 225100000X QA01266400 NJ Primary

Addresses

Primary practice location

605 Main Street
Hackensack, NJ 07601

Mailing address

605 Main Street
Hackensack, NJ 07601
Phone (201) 488-0488

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111213000026 NJ Practitioner - Physical Therapist in Private Practice 9436324944 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jag-One Physical Therapy LLCGroup PAC ID 2769584325, 334 clinicians

Practice addresses (Care Compare)

10 Woodbridge Ctr Dr
Suite 102
Woodbridge, NJ 07095-1153
Phone (732) 855-0380

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
QA01266400NJMDPhysical Therapist
024599-1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Jag-One Physical Therapy, LLC Physical Therapist CurrentSince Jul 20, 2020 Accepting new patients
Sports Physical Therapy of New York, P.C. Physical Therapist PastSince Dec 11, 2013 Accepting new patients
Sports Medicine Center of Bergen, PA Physical Therapist PastSince Sep 19, 2011 Accepting new patients

Locations

981 US Highway 22
Fl 2
Bridgewater, NJ 08807
Phone (908) 231-0511

221 Rockingham Row
Princeton, NJ 08540
Phone (609) 580-1520

622 Eagle Rock Ave
West Orange, NJ 07052
Phone (973) 669-0078

10 Woodbridge Center Dr
Ste 102
Woodbridge, NJ 07095
Phone (732) 588-6935

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318291200000",
    "number": "1891719431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 MAIN STREET",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "07601",
            "telephone_number": "201-488-0488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 MAIN STREET",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "07601",
            "telephone_number": "201-488-0488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALKIN",
        "first_name": "ANNA",
        "middle_name": "S",
        "name_prefix": "Ms.",
        "credential": "D.P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-27",
        "last_updated": "2011-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "024599-1",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "QA01266400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hackensack, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2011; 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.