Active NPI
Mary-Louise Jannicelli-Clare, P.T.
- Physical Therapist
- Rutherford, NJ
National Provider Identifier
1275696411
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 40QA00419300
- Practice address
- 21 The Terrace
Rutherford, NJ 07070 - Phone
- (201) 460-7459
- NPI assigned
- Dec 19, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 40QA00419300 | NJ | Primary |
Addresses
Primary practice location
21 The Terrace
Rutherford, NJ 07070
Mailing address
264 Boyden Ave
Maplewood, NJ 07040-3070
Phone (973) 761-0764
Other names 1
- Mary-Louise Jannicelli
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1350 State Route 23 N
Wayne, NJ 07470-5839
Phone 9737099200205
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rehabilitation Medicine Center of New Jersey P.a. | Current | Accepting new patients | |
| Brittco Inc. | Past | Accepting new patients |
Locations
1350 State Route 23
Wayne, NJ 07470
Phone (973) 628-4671
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.
-
- Rehabilitation Clinic/Center
- Wayne, NJ
- NPI 1275548653
-
dba Alpha Physical Therapy Associates
- Physical Therapy Clinic/Center
- Rutherford, NJ
- NPI 1932262185
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166486400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1463011200000",
"number": "1275696411",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "264 BOYDEN AVE",
"city": "MAPLEWOOD",
"state": "NJ",
"postal_code": "070403070",
"telephone_number": "973-761-0764",
"fax_number": "973-761-0112"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21 THE TERRACE",
"city": "RUTHERFORD",
"state": "NJ",
"postal_code": "07070",
"telephone_number": "201-460-7459"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JANNICELLI-CLARE",
"first_name": "MARY-LOUISE",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-19",
"last_updated": "2016-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NJ",
"license": "40QA00419300",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MARY-LOUISE",
"last_name": "JANNICELLI",
"credential": "P.T.",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Rutherford, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2016; 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.