Konrad Roslonek, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA01327000 Issued in NJ

Practice address

266-272 Chestnut St Ste a
Newark, NJ 07105-6521

Phone

(973) 732-3850

Fax

(732) 855-9755

NPI assigned

Nov 6, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2009

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)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Jag-One Physical Therapy, LLC

  • Physical Therapist
  • West Orange, NJ
  • NPI 1518017144
  Medicare reassignment Care Compare group NPD
• Twin Boro Physical Therapy Associates PA

  • Physical Therapist
  • Clark, NJ
  • NPI 1811937527
  Medicare reassignment NPD
• Twin Boro Physical Therapy Associates, PA

  • Occupational Therapist
  • Newark, NJ
  • NPI 1659874857
  NPD

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

{
    "created_epoch": "1257465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583280000000",
    "number": "1902133259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1014",
            "city": "CLARK",
            "state": "NJ",
            "postal_code": "070661014",
            "telephone_number": "732-855-9751",
            "fax_number": "732-855-9755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "266-272 CHESTNUT ST STE A",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071056521",
            "telephone_number": "973-732-3850",
            "fax_number": "732-855-9755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSLONEK",
        "first_name": "KONRAD",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-11-06",
        "last_updated": "2020-03-04",
        "certification_date": "2020-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01327000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "169667DBD",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Roseville Health Care LLC
• Roseville Health Center Inc.
• Roseville Medical Group PA
• Roseville Medical Society LLC
• Roseville Pediatric Care Center, P.a.
• Joel Hilton Ross, M.D.
• Movena Ross
• Sarah Ross, MD
• Sharmaine Gabrielle Ross, MD
• Stephen Rothbart, MD

• Physical Therapist in Newark, NJ
• Providers in Newark, 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 Mar 4, 2020; 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.