Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kim R Minervini, PT

Individual provider Physical Therapist · NPI 1275692824

Kim R Minervini, PT is a Physical Therapist in Private Practice in Ridgewood, New Jersey. Qualified in 1998, 28 years ago. Practices with Jag-One Physical Therapy LLC, a 328-clinician group and accepts Medicare assignment. Licensed in New Jersey.

Years since qualifying
28
Licensed in
NJ
In the registry since
2006
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.

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Practice location Address checks out

104 Chestnut St
Ridgewood, NJ 07450-2502
Phone: (201) 493-8111
Fax: (201) 493-8279
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 40QA00792200 (NJ)

Record details

NPI number1275692824
Entity typeIndividual (Type 1)
GenderFemale
Credentials PT
Sole proprietorNo
NPI enumeratedDecember 8, 2006
Last updated in NPPESAugust 29, 2013

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 1998 (28 years in practice)
Group practice Jag-One Physical Therapy Llc — 328 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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