Individual provider Active NPI

Jake Marzocca

  • Physical Therapist
  • Sayville, NY
National Provider Identifier
1093446197
Registry record updated Jun 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
91 Main St
Sayville, NY 11782-2501
Phone
(631) 983-2576
NPI assigned
Jun 20, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

91 Main St
Sayville, NY 11782-2501

Mailing address

576 Broadhollow Rd
Melville, NY 11747-5002
Phone (631) 359-5859

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220906003129 NY Practitioner - Physical Therapist in Private Practice 7214311521 Reassigns benefits to 1 organization
I20240923004156 FL Practitioner - Physical Therapist in Private Practice 7214311521 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Suncoast Sports and Orthopedic TherapyGroup PAC ID 0446243729, 6 clinicians

Practice addresses (Care Compare)

5535 Park St N
St Petersburg, FL 33709-6309
Phone (727) 209-0579

Merit-based Incentive Payment System (MIPS)

Final score
91.17 of 100Reported as group
Quality
94.53
Improvement activities
40
Cost
77.86

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
048993NYMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist CurrentSince May 21, 2022 Accepting new patients
Suncoast Sports and Orthopedic Therapy CurrentSince Sep 25, 2024 Accepting new patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist Current Accepting new patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist CurrentSince May 21, 2022 Accepting new patients
Suncoast Sports and Orthopedic Therapy Physical Therapist CurrentSince Sep 25, 2024 Accepting new patients

Locations

40 66th St N
St Petersburg, FL 33710
Phone (727) 345-3346

5535 Park St N
St Petersburg, FL 33709
Phone (727) 209-0579

123 Grove Ave
Cedarhurst, NY 11516
Phone (516) 374-4248

8002 Kew Gardens Rd
Fl 4
Kew Gardens, NY 11415
Phone (718) 263-7500

576 Broadhollow Rd
Melville, NY 11747

91 Main St
Sayville, NY 11782
Phone (631) 589-0999

2142 Utopia Pkwy
Whitestone, NY 11357
Phone (718) 767-0610

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1655683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655683200000",
    "number": "1093446197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "576 BROADHOLLOW RD",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117475002",
            "telephone_number": "631-359-5859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91 MAIN ST",
            "city": "SAYVILLE",
            "state": "NY",
            "postal_code": "117822501",
            "telephone_number": "631-983-2576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARZOCCA",
        "first_name": "JAKE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-20",
        "last_updated": "2022-06-20",
        "certification_date": "2022-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sayville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2022; 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.