Kennedy M Ilagan, PT/DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA02203100 Issued in NJ

Practice address

525 Route 73
Suite 303a
Marlton, NJ 08053-9644

Phone

(856) 267-5660

NPI assigned

Sep 22, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Twin Boro Physical Therapy Associates, PAGroup PAC ID 8527962950, 89 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.

• Twin Boro Physical Therapy Associates PA

  • Physical Therapist
  • Clark, NJ
  • NPI 1811937527
  Medicare reassignment Care Compare group NPD
• Breakthru Physical Therapy LLC

  • Physical Therapy Clinic/Center
  • Medford, NJ
  • NPI 1083750624

  Physical Therapist

  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": "1695340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695340800000",
    "number": "1932988656",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 ROUTE 73",
            "address_2": "SUITE 303A",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080539644",
            "telephone_number": "856-267-5660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ILAGAN",
        "first_name": "KENNEDY",
        "middle_name": "M",
        "credential": "PT/DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-22",
        "last_updated": "2023-09-22",
        "certification_date": "2023-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA02203100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Bryan Huttinger, PT
• Richard James Huynh
• Hydration Clinics of America
• I. Harvey Getzoff, PA
• Madison Caroline Iannotta
• Kiersten Ilaoa
• Heather Lisa Ilconich, LCSW
• In This Moment Recovery
• Inadvance Medicine Associates East
• Inandout Enterprises LLC

• Physical Therapist in Marlton, NJ
• Providers in Marlton, 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 Sep 22, 2023; 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.