Individual provider Active NPI

Jillian Picarillo, DPT

  • Physical Therapist
  • Wynantskill, NY
National Provider Identifier
1275310567
Registry record updated Sep 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
050684-01 Issued in NY
Practice address
86 Main Ave
Wynantskill, NY 12198-7541
Phone
(518) 326-0702
Fax
(518) 326-0706
NPI assigned
Sep 11, 2023
Last updated
Sep 11, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2023

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 050684-01 NY Primary

Addresses

Primary practice location

86 Main Ave
Wynantskill, NY 12198-7541

Mailing address

506 Campbell Ave
Troy, NY 12180-6243
Phone (518) 203-6761

Other practice location 1

506 Campbell Ave
Troy, NY 12180-6243
Phone (518) 203-6761

Other practice location 2

290 Speigletown Rd
Troy, NY 12182-1124
Phone (518) 279-2740

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231030002364 NY Practitioner - Physical Therapist in Private Practice 8628424447 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nje PT Movement PLLCGroup PAC ID 9739408295, 18 clinicians

Practice addresses (Care Compare)

86 Main Ave
Wynantskill, NY 12198-7541
Phone (518) 326-0702

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
050684NYMDOral and Maxillofacial Surgery (Dentist)
050684-01NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Nje PT Movement PLLC Physical Therapist CurrentSince Aug 30, 2023 Accepting new patients

Locations

290 Speigletown Rd
Troy, NY 12182
Phone (518) 279-2740

506 Campbell Ave
Troy, NY 12180
Phone (518) 203-6761

86 Main Ave
Wynantskill, NY 12198
Phone (518) 326-0702

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1694390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694390400000",
    "number": "1275310567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 CAMPBELL AVE",
            "city": "TROY",
            "state": "NY",
            "postal_code": "121806243",
            "telephone_number": "518-203-6761",
            "fax_number": "518-203-6762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "86 MAIN AVE",
            "city": "WYNANTSKILL",
            "state": "NY",
            "postal_code": "121987541",
            "telephone_number": "518-326-0702",
            "fax_number": "518-326-0706"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "506 Campbell Ave",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "NY",
            "postal_code": "121806243",
            "country_code": "US",
            "telephone_number": "518-203-6761",
            "fax_number": "518-203-6762",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "290 Speigletown Rd",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "NY",
            "postal_code": "121821124",
            "country_code": "US",
            "telephone_number": "518-279-2740",
            "fax_number": "518-203-6762",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PICARILLO",
        "first_name": "JILLIAN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-11",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "050684-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wynantskill, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2023; 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.