Individual provider Active NPI

Janet Petrucelli, MD

  • Physical Medicine & Rehabilitation Physician
  • Teaneck, NJ
National Provider Identifier
1154404358
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
MA64903 Issued in NJ
Practice address
1 Degraw Ave
Teaneck, NJ 07666-4000
Phone
(201) 928-0200
Fax
(201) 928-0820
NPI assigned
Oct 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X MA64903 NJ Primary

Addresses

Primary practice location

1 Degraw Ave
Teaneck, NJ 07666-4000

Mailing address

1 Degraw Ave
Teaneck, NJ 07666-4000
Phone (201) 928-0200

Other identifiers 1

IdentifierTypeStateIssuer
6818706MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070404000332 NJ Practitioner - Physical Medicine and Rehabilitation 0547364341 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Aspen Medical Associates, PA Physical Medicine & Rehabilitation CurrentSince Oct 2, 2006 Accepting new patients
Aspen Medical Associates, LLC Physical Medicine & Rehabilitation Past Accepting new patients

Locations

1 Degraw Ave
Teaneck, NJ 07666
Phone (201) 837-2174

197 Cedar Ln
Teaneck, NJ 07666
Phone (201) 836-7171

197 Cedar Ln
Ste 2
Teaneck, NJ 07666
Phone (201) 591-9840

Organizations & group practices 2

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": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154404358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 DEGRAW AVE",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076664000",
            "telephone_number": "201-928-0200",
            "fax_number": "201-928-0820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 DEGRAW AVE",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076664000",
            "telephone_number": "201-928-0200",
            "fax_number": "201-928-0820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRUCELLI",
        "first_name": "JANET",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NJ",
            "license": "MA64903",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6818706",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Teaneck, NJ

Sources for this page

Verify at the official NPI Registry.