Jacob Philipose, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA01178700 Issued in NJ

Practice address

13 Brighton Ave
Belleville, NJ 07109-1225

Phone

(201) 456-8791

NPI assigned

Nov 16, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2002

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Jag-One Physical Therapy, LLC

  • Physical Therapist
  • West Orange, NJ
  • NPI 1518017144
  Medicare reassignment

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

{
    "created_epoch": "1258329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258329600000",
    "number": "1003143744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 BRIGHTON AVE",
            "city": "BELLEVILLE",
            "state": "NJ",
            "postal_code": "071091225",
            "telephone_number": "201-456-8791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 BRIGHTON AVE",
            "city": "BELLEVILLE",
            "state": "NJ",
            "postal_code": "071091225",
            "telephone_number": "201-456-8791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILIPOSE",
        "first_name": "JACOB",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-11-16",
        "last_updated": "2009-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01178700",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "026895-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caridad D. Peguero, MS, CCC-SLP
• Susana Pereira, APN
• Sophia Rose Perez
• Yaniset Perez
• Mirsada Petovic
• Physician Visiting Care
• Physione Physical Therapy P.C.
• Princess Keanne O Pineda, COTA
• Keith Pishna, LCSW
• Doris Lisette Platero, FNP-C

• Physical Therapist in Belleville, NJ
• Providers in Belleville, 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 Nov 16, 2009; 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.