Jacqueline Pedersen

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

1003 Easton Rd
Willow Grove, PA 19090-2027

Phone

(215) 659-7759

NPI assigned

Aug 15, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Willow Grove Physical Therapy LLCGroup PAC ID 0749189256, 22 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Willow Grove Physical Therapy, LLC

  • Physical Therapy Clinic/Center
  • Willow Grove, PA
  • NPI 1083659783

  Physical Therapist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1502755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1023534849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 SARATOGA WAY",
            "city": "HARLEYSVILLE",
            "state": "PA",
            "postal_code": "194382980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 EASTON RD",
            "city": "WILLOW GROVE",
            "state": "PA",
            "postal_code": "190902027",
            "telephone_number": "215-659-7759"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 N York Rd",
            "address_purpose": "LOCATION",
            "city": "Hatboro",
            "state": "PA",
            "postal_code": "190403149",
            "country_code": "US",
            "telephone_number": "215-412-2501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEDERSEN",
        "first_name": "JACQUELINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-15",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Path -to -Recovery LLC
• Maureen Patt-Bogut, P.A.
• Donna Lee Patterson, PHD CRNP
• Peaceful Journey Inc
• Wendy Pecorella, MD
• Pediatric Specialty Care, P.C.
• Heather Pelletier
• Phedra Penn, M.D.
• Pennsylvania CVS Pharmacy, L.L.C.
• Christopher Michael Perry, DPT

• Physical Therapist in Willow Grove, PA
• Providers in Willow Grove, PA by specialty
• Physical Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.