Individual provider Active NPI

Guillerma Florentino, PT

  • Physical Therapist
  • East Brunswick, NJ
National Provider Identifier
1982763975
Registry record updated May 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA00475700 Issued in NJ
Practice address
150A Tices LN
East Brunswick, NJ 08816-2015
Phone
(732) 254-5553
Fax
(732) 238-6194
NPI assigned
Dec 6, 2006
Last updated
May 6, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2013

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 40QA00475700 NJ Primary

Addresses

Primary practice location

150A Tices LN
East Brunswick, NJ 08816-2015

Mailing address

150A Tices LN
East Brunswick, NJ 08816-2015
Phone (732) 254-5553

Other names 1

  • Guillerma Escano Medrano Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051025000349 NJ Practitioner - Physical Therapist in Private Practice 5092740357 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Encompass Spinal and Integrated WellnessGroup PAC ID 7214357755, 2 clinicians

Practice addresses (Care Compare)

6 Brier Hill Court
Building E6 B
East Brunswick, NJ 08816
Phone (732) 353-6677

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA00475700NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Craig Rallo Chiropractor,LLC CurrentSince Aug 1, 2020 Accepting new patients
Encompass Spinal and Integrated Wellness CurrentSince Feb 12, 2022 Accepting new patients
Old Bridge Spine & Wellness Center,PA Physical Therapist CurrentSince Dec 7, 2019 Accepting new patients
Innovative Wellness Center PC CurrentSince Nov 24, 2020 Accepting new patients
Key Physmed PC Past Accepting new patients

Locations

465 Cranbury Rd
Ste 102
East Brunswick, NJ 08816
Phone (732) 336-9878

15 E Railroad Ave
Jamesburg, NJ 08831
Phone (732) 656-1740

505 Main St
Ste B
Lanoka Harbor, NJ 08734
Phone (609) 994-3730

144 State Route 34
Matawan, NJ 07747
Phone (732) 316-5895

2698 Highway 516
Ste C
Old Bridge, NJ 08857
Phone (732) 679-1100

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367798400000",
    "number": "1982763975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150A TICES LN",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088162015",
            "telephone_number": "732-254-5553",
            "fax_number": "732-238-6194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150A TICES LN",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088162015",
            "telephone_number": "732-254-5553",
            "fax_number": "732-238-6194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLORENTINO",
        "first_name": "GUILLERMA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-06",
        "last_updated": "2013-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA00475700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GUILLERMA",
            "last_name": "MEDRANO",
            "middle_name": "ESCANO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in East Brunswick, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2013; 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.