Justin Scott Bagley, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA01204500 Issued in NJ

Practice address

1250 State Route 31
Lebanon, NJ 08833-3238

Phone

(908) 730-6640

NPI assigned

Aug 31, 2006

Sex

Male

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, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Proactivity Fitness Physical Therapy AssociatesGroup PAC ID 1658784103, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Proactivity Fitness Physical Therapy Associates

  • Physical Therapist
  • Lebanon, NJ
  • NPI 1265038160
  Medicare reassignment Care Compare group NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606953600000",
    "number": "1982715637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 STATE ROUTE 31",
            "city": "LEBANON",
            "state": "NJ",
            "postal_code": "088333238",
            "telephone_number": "908-730-6640",
            "fax_number": "908-730-0468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 STATE ROUTE 31",
            "city": "LEBANON",
            "state": "NJ",
            "postal_code": "088333238",
            "telephone_number": "908-730-6640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAGLEY",
        "first_name": "JUSTIN",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-12-03",
        "certification_date": "2020-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01204500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Acupuncture Medicine
• Christina Marie Ancona, LCSW
• Annandale Family Practice LLC
• Annandale Family Practice LLC
• Judith Ann Barberio, PH.D., RN, APN,C
• Battaglia LLC
• Elizabeth A Battaglia-Price, DC
• Elizabeth A Biamonte, LPC
• Angela Bindics

• Physical Therapist in Lebanon, NJ
• Providers in Lebanon, 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 Dec 3, 2020; 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.