Jay Peacock, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

021156-1 Issued in NY

Practice address

1367 Washington Ave
Suite 100
Albany, NY 12206-1043

Phone

(518) 438-7926

Fax

(518) 438-8364

NPI assigned

Dec 13, 2005

Last updated

Feb 7, 2018By the provider in NPPES

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

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Nicolla and Associates PT and OT Services PLLCGroup PAC ID 7315836848, 28 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Nicolla and Associates, PT & OT Services, PLLC

  • Specialist
  • Latham, NY
  • NPI 1487633152

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Thomas Nicolla Consulting Services, PLLC

  • Physical Therapist
  • Stamford, NY
  • NPI 1770636060
  NPD

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

{
    "created_epoch": "1134432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517961600000",
    "number": "1235114398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 TROY SCHENECTADY RD",
            "address_2": "SUITE 209",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102442",
            "telephone_number": "518-786-1667",
            "fax_number": "518-786-1954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1367 WASHINGTON AVE",
            "address_2": "SUITE 100",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122061043",
            "telephone_number": "518-438-7926",
            "fax_number": "518-438-8364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEACOCK",
        "first_name": "JAY",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-13",
        "last_updated": "2018-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "021156-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02262251",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "650021313",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "CC0366",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisamarie Payne, NP
• William Jason Payne, APRN
• William R Payne
• Nicholas Joseph Pazienza, PH.D.
• Kristen Morgan Peace, M.D.
• Rachael Peals
• Emily Monica Pearce, OTR/L
• Jennifer M Pearce, M.D.
• Pearl Street Counseling Center, Inc.
• Pearle Vision (tone optical)

• Physical Therapist in Albany, NY
• Providers in Albany, 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 Feb 7, 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.