Individual provider Active NPI

Jerry George

  • Physical Therapist
  • Englewood Cliffs, NJ
National Provider Identifier
1922826700
Registry record updated Sep 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
053215 Issued in NY
Practice address
180 Sylvan Ave Ste 401
Englewood Cliffs, NJ 07632-2512
Phone
(718) 650-6230
NPI assigned
Sep 30, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2024

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 053215 NY Primary

Addresses

Primary practice location

180 Sylvan Ave Ste 401
Englewood Cliffs, NJ 07632-2512

Mailing address

70 Foltim Way
Congers, NY 10920-1423
Phone (267) 632-3526

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241014002571 NY Practitioner - Physical Therapist in Private Practice 3779015938 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
053215NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Link Home Therapy Services of Ny-PT OT SLP PLLC CurrentSince Sep 29, 2024 Accepting new patients

Locations

180 Sylvan Ave
Ste 4
Englewood Cliffs, NJ 07632
Phone (347) 841-8943

108 S Franklin Ave
Ste 10
Valley Stream, NY 11580

Organizations & group practices 1

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": "1727654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1922826700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 FOLTIM WAY",
            "city": "CONGERS",
            "state": "NY",
            "postal_code": "109201423",
            "telephone_number": "267-632-3526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 SYLVAN AVE STE 401",
            "city": "ENGLEWOOD CLIFFS",
            "state": "NJ",
            "postal_code": "076322512",
            "telephone_number": "718-650-6230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEORGE",
        "first_name": "JERRY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-09-30",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "053215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood Cliffs, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2024; 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.