Center for Sports Physical Therapy, LLC
NPI 1568219954ActiveOrganization· Physical Therapist· Freehold, NJ
Physical Therapist in Freehold, New Jersey, registered in NPPES in May 2024. The authorized official on file is Jessie Ganon, PT, Owner/Medical Provider. Enrolled in Medicare as part b supplier - physical/occupational therapy group in private practice.
Overview
| NPI | 1568219954 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | May 2, 2024 |
| Last updated in NPPES | May 2, 2024 |
| Certified by provider | May 2, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Physical/Occupational Therapy Group in Private Practice (NJ) |
|---|
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