Jake Creagh

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA02025600 Issued in NJ

Practice address

150 N Midland Ave
Saddle Brook, NJ 07663-5926

Phone

(201) 712-5533

Fax

(201) 712-5551

NPI assigned

Aug 11, 2021

Last updated

Aug 11, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Professional Occupational and Physical Therapy, PLLCGroup PAC ID 3779873401, 497 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.

• Professional Occupational & Physical Therapy, PLLC

  • Occupational Therapist
  • Sicklerville, NJ
  • NPI 1215487772

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Professional Occupational & Physical Therapy, PLLC

  • Occupational Therapist
  • Randolph, NJ
  • NPI 1104376680

  Physical Therapist

  NPD
• Professional Occupational & Physical Therapy, PLLC

  • Occupational Therapist
  • Whitestone, NY
  • NPI 1487104261

  Physical Therapist

  NPD

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

{
    "created_epoch": "1628640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628640000000",
    "number": "1326713413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "576 BROADHOLLOW RD",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117475002",
            "telephone_number": "631-359-5859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 N MIDLAND AVE",
            "city": "SADDLE BROOK",
            "state": "NJ",
            "postal_code": "076635926",
            "telephone_number": "201-712-5533",
            "fax_number": "201-712-5551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CREAGH",
        "first_name": "JAKE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-08-11",
        "last_updated": "2021-08-11",
        "certification_date": "2021-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA02025600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Committed Medical Services
• Comprehensive Orthopaedic & Spine Institute LLC
• Comprehensive Pain Medicine and Anesthesia Group, PC
• Henry John Cooke, DC
• Todd J. Cooperman, M.D.
• Kayla Noel Critser, PT, DPT
• D&C Dental Care
• Bianca Marie Davanzo
• La Shanee Renee Davis, MSED, THD
• Isabelly Candido De Jong

• Physical Therapist in Saddle Brook, NJ
• Providers in Saddle Brook, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2021; 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.