Organization Active NPI

Jeevam Therapy

  • Physical Therapist
  • Edison, NJ
National Provider Identifier
1982953071
Registry record updated Mar 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01061600 Issued in NJ
Legal business name
JEEVAM THERAPY
Practice address
608 Merrywood Dr.
Edison, NJ 08817-2535
Phone
(732) 910-3995
NPI assigned
Sep 5, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2017

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

Authorized official

Name
Eva Mohanty, MSPT., DPT..NPI 1659628709
Title
President/Owner
Phone
(732) 910-3995

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 40QA01061600 NJ Primary

Addresses

Primary practice location

608 Merrywood Dr.
Edison, NJ 08817-2535

Mailing address

608 Merrywood Dr.
Edison, NJ 08817-2535
Phone (732) 910-3995

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170321000410 NJ Part B Supplier - Clinic/Group Practice 1355626060 Receives reassigned benefits from 1 practitioner
Practice locations: Edison, NJ; Metuchen, NJ; Paramus, NJ

National Provider Directory

National Provider Directory

Locations

312 Amboy Ave
Ste B
Metuchen, NJ 08840
Phone (732) 535-7323

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1346803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489449600000",
    "number": "1982953071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 MERRYWOOD DR.",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088172535",
            "telephone_number": "732-910-3995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 MERRYWOOD DR.",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088172535",
            "telephone_number": "732-910-3995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEEVAM THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-05",
        "last_updated": "2017-03-14",
        "status": "A",
        "authorized_official_last_name": "MOHANTY",
        "authorized_official_first_name": "EVA",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "732-910-3995",
        "authorized_official_credential": "MSPT., DPT.."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01061600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edison, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.