Active NPI
Timothy M Bambrick, DPT
- Physical Therapist
- Guttenberg, NJ
National Provider Identifier
1962813568
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 40QA01547600
- Practice address
- 7002 Kennedy Blvd E
Guttenberg, NJ 07093-4929 - Phone
- (516) 287-4955
- NPI assigned
- May 16, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 40QA01547600 | NJ | Primary |
Addresses
Primary practice location
7002 Kennedy Blvd E
Guttenberg, NJ 07093-4929
Mailing address
7002 Kennedy Blvd E
Guttenberg, NJ 07093-4929
Phone (516) 287-4955
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036007 | NY | MD | General Practice Dentistry |
| 40QA01547600 | NJ | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| PMK Rehab,LLC | Physical Therapist | Past | Accepting new patients |
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": "1400198400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1400198400000",
"number": "1962813568",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7002 KENNEDY BLVD E",
"city": "GUTTENBERG",
"state": "NJ",
"postal_code": "070934929",
"telephone_number": "516-287-4955"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7002 KENNEDY BLVD E",
"city": "GUTTENBERG",
"state": "NJ",
"postal_code": "070934929",
"telephone_number": "516-287-4955"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAMBRICK",
"first_name": "TIMOTHY",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-05-16",
"last_updated": "2014-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NJ",
"license": "40QA01547600",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Guttenberg, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.