Allen Jacob, PT,DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

052799 Issued in NY

Practice address

1441 South Ave
Staten Island, NY 10314-3779

Phone

(718) 303-9777

Fax

(718) 303-9778

NPI assigned

Aug 12, 2024

Sex

Male

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 NY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

RB Physical and Occupational Therapy, PLLCGroup PAC ID 5294870226, 312 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.

• RB Physical and Occupational Therapy PLLC

  • Physical Therapist
  • Brooklyn, NY
  • NPI 1790013282
  Medicare reassignment Care Compare group NPD
• One on One Physical Therapy Services PLLC

  • Physical Therapist
  • Brooklyn, NY
  • NPI 1740423219
  NPD (past)

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

{
    "created_epoch": "1723420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1023849015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "195 MARTIN AVE BLDG SUITE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103144325",
            "telephone_number": "917-525-6773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 SOUTH AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103143779",
            "telephone_number": "718-303-9777",
            "fax_number": "718-303-9778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOB",
        "first_name": "ALLEN",
        "credential": "PT,DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-12",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "052799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly A Jackson, OTR/L
• Rebecca Sabrina Jackson, CRPA
• Sharon Jackson
• Starr Shalae Jackson
• Jaclyn Hunt
• Jeremy Jacob, PHARMD
• Jeryl-Lynne Jacob, D.C.
• Lindsey Jacob, LCSW
• Linsy Jacob, PHARM D
• Smrithy Jacob, MD

• Physical Therapist in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2024; 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.