Individual provider Active NPI

Brad A Jongejan, DPT

  • Physical Therapist
  • Albuquerque, NM
National Provider Identifier
1952593642
Registry record updated Sep 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
4411 San Mateo Blvd NE Ste 11
Albuquerque, NM 87109-2011
Phone
(515) 217-3907
Fax
(505) 348-0063
NPI assigned
Aug 15, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT00010271 WA
Physical Therapist 225100000X NM Primary

Addresses

Primary practice location

4411 San Mateo Blvd NE Ste 11
Albuquerque, NM 87109-2011

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (866) 370-8206

Other practice location 1

35 Technology Pkwy S
Ste 150
Norcross, GA 30092-2996
Phone (770) 416-2340

Other practice location 2

16310 Bothell Everett Hwy Ste C
Mill Creek, WA 98012-1284
Phone (425) 582-5526

Other practice location 3

4220 Hoyt Ave
Everett, WA 98203-2317
Phone (425) 258-5330

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, NM2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230608003254 WA Practitioner - Physical Therapist in Private Practice 1355708199 Reassigns benefits to 1 organization
I20241009000449 NM Practitioner - Physical Therapist in Private Practice 1355708199 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physical Therapy at Dawn LLCGroup PAC ID 0042221889, 29 clinicians

Practice addresses (Care Compare)

4411 San Mateo Blvd NE
Suite E11
Albuquerque, NM 87109-2029
Phone (630) 296-2223

Merit-based Incentive Payment System (MIPS)

Final score
86.33 of 100Reported as group
Quality
88.06
Improvement activities
40
Cost
76.31

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT00010271WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Apple Physical Therapy LLC Physical Therapist CurrentSince May 8, 2023 Accepting new patients
Apple Physical Therapy, LLC Physical Therapist CurrentSince May 8, 2023 Accepting new patients
Physical Therapy at Dawn, LLC Physical Therapist CurrentSince Aug 26, 2024 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

6330 Riverside Plaza Ln NW
Albuquerque, NM 87120
Phone (505) 312-7930

600 Central Ave SE
Ste D
Albuquerque, NM 87102
Phone (505) 242-2294

4411 San Mateo Blvd NE
Ste 11
Albuquerque, NM 87109
Phone (505) 217-3907

4220 Hoyt Ave
Everett, WA 98203
Phone (425) 258-5330

32030 23rd Ave S
Federal Way, WA 98003
Phone (253) 946-4852

130 Marvin Rd SE
Ste 203
Lacey, WA 98503
Phone (360) 456-3300

16310 Bothell Hwy
Ste C
Mill Creek, WA 98012
Phone (425) 582-5526

Networks

  • Freedom Health HMO Network

Organizations & group practices 3

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": "1187136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727049600000",
    "number": "1952593642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "866-370-8206",
            "fax_number": "517-435-3670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4411 SAN MATEO BLVD NE STE 11",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871092011",
            "telephone_number": "515-217-3907",
            "fax_number": "505-348-0063"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "35 Technology Pkwy S",
            "address_2": "Ste 150",
            "address_purpose": "LOCATION",
            "city": "Norcross",
            "state": "GA",
            "postal_code": "300922996",
            "country_code": "US",
            "telephone_number": "770-416-2340",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16310 Bothell Everett Hwy Ste C",
            "address_purpose": "LOCATION",
            "city": "Mill Creek",
            "state": "WA",
            "postal_code": "980121284",
            "country_code": "US",
            "telephone_number": "425-582-5526",
            "fax_number": "425-245-1019",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4220 Hoyt Ave",
            "address_purpose": "LOCATION",
            "city": "Everett",
            "state": "WA",
            "postal_code": "982032317",
            "country_code": "US",
            "telephone_number": "425-258-5330",
            "fax_number": "425-258-6118",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JONGEJAN",
        "first_name": "BRAD",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-15",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00010271",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NM",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2024; 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.