Individual provider Active NPI

Jay Allan Bernasconi, DPT, OCS

  • Physical Therapist
  • Quincy, MA
National Provider Identifier
1154416949
Registry record updated Jan 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5087 Issued in MA
Practice address
21 Totman St
First Floor
Quincy, MA 02169-7564
Phone
(617) 770-4167
Fax
(617) 770-0971
NPI assigned
Oct 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2008

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 5087 MA Primary

Addresses

Primary practice location

21 Totman St
First Floor
Quincy, MA 02169-7564

Mailing address

21 Totman St
First Floor
Quincy, MA 02169-7564
Phone (617) 770-4167

Other identifiers 1

IdentifierTypeStateIssuer
BEY65909OtherMABC/BS OF MA.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100120000186 MA Practitioner - Physical Therapist in Private Practice 3173515525 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Massachusetts Medical School, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
J.B. Rehabilitation Associates, IncGroup PAC ID 1153313598, 14 clinicians

Practice addresses (Care Compare)

104 Quarry St
FL 1
Quincy, MA 02169-4175
Phone (617) 770-4167

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
J.B. Rehabilitation Associates, Inc Physical Therapist CurrentSince Oct 23, 1987 Accepting new patients
J B Rehabilitation Associates, Inc. Past Accepting new patients
JK Therapy Associates, LLC Past Accepting new patients

Locations

104 Quarry St
Fl 1
Quincy, MA 02169
Phone (617) 770-4167

Organizations & group practices 3

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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201564800000",
    "number": "1154416949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 TOTMAN ST",
            "address_2": "FIRST FLOOR",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021697564",
            "telephone_number": "617-770-4167",
            "fax_number": "617-770-0971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 TOTMAN ST",
            "address_2": "FIRST FLOOR",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021697564",
            "telephone_number": "617-770-4167",
            "fax_number": "617-770-0971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNASCONI",
        "first_name": "JAY",
        "middle_name": "ALLAN",
        "name_prefix": "Dr.",
        "credential": "DPT, OCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2008-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "5087",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF MA.",
            "identifier": "BEY65909",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2008; 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.