Individual provider Active NPI

Kelsey Verblaauw

  • Physical Therapist
  • East Hanover, NJ
National Provider Identifier
1942881602
Registry record updated Apr 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01995700 Issued in NJ
Practice address
11 Eagle Rock Ave Ste 201
East Hanover, NJ 07936-3167
Phone
(973) 887-9000
Fax
(973) 887-3816
NPI assigned
Apr 15, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2021

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 40QA01995700 NJ Primary

Addresses

Primary practice location

11 Eagle Rock Ave Ste 201
East Hanover, NJ 07936-3167

Mailing address

11 Eagle Rock Ave Ste 201
East Hanover, NJ 07936-3167
Phone (973) 887-9000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210421001294 NJ Practitioner - Physical Therapist in Private Practice 3476961905 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hudson Physio and Sports PCGroup PAC ID 2668810557, 3 clinicians

Practice addresses (Care Compare)

74 Hudson St
Suite 1
Hoboken, NJ 07030-6193
Phone (877) 576-4681

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA01995700NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
United Sports Care & Physical Therapy Physical Therapist CurrentSince Apr 15, 2021 Accepting new patients
Hudson Physio & Sports PC Physical Therapist CurrentSince Apr 11, 2024 Accepting new patients
Hudson Premiere Rehabilitation & Sports Therapy Physical Therapist CurrentSince May 2, 2022 Accepting new patients
Sportscare of America, PC Physical Therapist CurrentSince Apr 15, 2021 Accepting new patients
Sportscare Institute, Inc. Physical Therapist Past Accepting new patients

Locations

47 S Washington Ave
Bergenfield, NJ 07621
Phone (201) 384-2525

1161 Burnt Tavern Rd
Brick, NJ 08724
Phone (732) 458-1255

197 Ridgedale Ave
Cedar Knolls, NJ 07927
Phone (973) 292-0700

197 Ridgedale Ave
Ste 155
Cedar Knolls, NJ 07927
Phone (973) 605-5115

11 Eagle Rock Ave
Ste 201
East Hanover, NJ 07936
Phone (973) 887-0115

74 Hudson St
Ste 1
Hoboken, NJ 07030
Phone (877) 576-4681

140 N Route 17
Ste 272
Paramus, NJ 07652
Phone (201) 261-4343

80 Oak Hill Rd
Red Bank, NJ 07701
Phone (732) 741-2313

111 W Water St
Toms River, NJ 08753
Phone (732) 473-9440

530 Lakehurst Rd
Ste 202204
Toms River, NJ 08755
Phone (732) 349-1201

4800 Broadway
Ste 212
Union City, NJ 07087
Phone (201) 766-1728

Organizations & group practices 5

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": "1618444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618444800000",
    "number": "1942881602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 EAGLE ROCK AVE STE 201",
            "city": "EAST HANOVER",
            "state": "NJ",
            "postal_code": "079363167",
            "telephone_number": "973-887-9000",
            "fax_number": "973-887-3816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 EAGLE ROCK AVE STE 201",
            "city": "EAST HANOVER",
            "state": "NJ",
            "postal_code": "079363167",
            "telephone_number": "973-887-9000",
            "fax_number": "973-887-3816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERBLAAUW",
        "first_name": "KELSEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-15",
        "last_updated": "2021-04-15",
        "certification_date": "2021-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01995700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Hanover, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2021; 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.