Individual provider Active NPI

Rovy Salenga Samson, PT

  • Physical Therapist
  • Freehold, NJ
National Provider Identifier
1902858236
Registry record updated Dec 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
025536 Issued in NY
Practice address
80 Scenic Dr
Freehold, NJ 07728-5210
Phone
(732) 863-6900
NPI assigned
May 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2010

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 025536 NY Primary

Addresses

Primary practice location

80 Scenic Dr
Freehold, NJ 07728-5210

Mailing address

91 Wood Duck CT
Freehold, NJ 07728-9522
Phone (732) 677-2839

Other identifiers 2

IdentifierTypeStateIssuer
025536OtherNYNYS LICENSE
40QA01144100OtherNJNJ LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090501000174 NJ Practitioner - Physical Therapist in Private Practice 6406904432 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Physical Medicine, LLCGroup PAC ID 4284879792, 6 clinicians

Practice addresses (Care Compare)

103 Professional View Dr
Freehold, NJ 07728-7902

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
025536NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist CurrentSince Apr 23, 2021 Accepting new patients
At Home by Enhance Therapies LLC Physical Therapist CurrentSince Jan 1, 2025 Accepting new patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist CurrentSince Apr 23, 2021 Accepting new patients
Advanced Physical Medicine, LLC Physical Therapist CurrentSince Oct 7, 2024 Accepting new patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist Current Accepting new patients
Innovative Wellness Center PC CurrentSince May 2, 2022 Accepting new patients
Ascend Physical Therapy and Rehab PC Current Accepting new patients
Garden State Spine and Pain Institute LLC Physical Therapist PastSince Jan 2, 2023 Accepting new patients

Locations

103 Professional View Dr
Ste 103
Freehold, NJ 07728
Phone (732) 780-5179

411 Hackensack Ave
Ste 200
Hackensack, NJ 07601
Phone (732) 987-3833

15 E Railroad Ave
Jamesburg, NJ 08831
Phone (732) 656-1740

400 Route 70
Lakewood, NJ 08701
Phone (732) 802-7512

1 Greenwood Ave
Montclair, NJ 07042
Phone (973) 746-2424

524 Williamstown Rd
Ste B1
Sicklerville, NJ 08081
Phone (856) 516-0591

524 Williamstown Rd
Sicklerville, NJ 08081
Phone (856) 262-9564

576 Broadhollow Rd
Melville, NY 11747

Organizations & group practices 8

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": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292284800000",
    "number": "1902858236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91 WOOD DUCK CT",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077289522",
            "telephone_number": "732-677-2839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 SCENIC DR",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077285210",
            "telephone_number": "732-863-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMSON",
        "first_name": "ROVY",
        "middle_name": "SALENGA",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2010-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "025536",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS LICENSE",
            "identifier": "025536",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NJ LICENSE",
            "identifier": "40QA01144100",
            "state": "NJ"
        }
    ],
    "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 Dec 14, 2010; 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.