Active NPI
Krystal Roth
- Physical Therapy Assistant
- Galloway, NJ
National Provider Identifier
1922998657
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- TE013381
- Practice address
- 45 S New York Rd Ste 217
Galloway, NJ 08205-3820 - Phone
- (609) 770-4522
- NPI assigned
- Jul 4, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | TE013381 | NJ | Primary |
| Physical Therapy Assistant | 225200000X | TE013381 | PA |
Addresses
Primary practice location
45 S New York Rd Ste 217
Galloway, NJ 08205-3820
Mailing address
16 Beeman PL
Succasunna, NJ 07876-1336
Phone (973) 796-7711
Other names 1
- Krystal Atieh
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TE013381 | NJ | MD | Physical Therapy Assistant |
| TE013381 | PA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1751587200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1752019200000",
"number": "1922998657",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16 BEEMAN PL",
"city": "SUCCASUNNA",
"state": "NJ",
"postal_code": "078761336",
"telephone_number": "973-796-7711"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "45 S NEW YORK RD STE 217",
"city": "GALLOWAY",
"state": "NJ",
"postal_code": "082053820",
"telephone_number": "609-770-4522"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROTH",
"first_name": "KRYSTAL",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-07-04",
"last_updated": "2025-07-09",
"certification_date": "2025-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "NJ",
"license": "TE013381",
"primary": true
},
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "PA",
"license": "TE013381",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KRYSTAL",
"last_name": "ATIEH",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Galloway, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.