Individual provider Active NPI

Jake Alexander Squilla, PT, DPT

  • Physical Therapist
  • Franklin Lakes, NJ
National Provider Identifier
1336009315
Registry record updated Nov 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA02384400 Issued in NJ
Practice address
795 Franklin Ave
Franklin Lakes, NJ 07417-1368
Phone
(201) 474-3341
NPI assigned
Nov 13, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2025

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 40QA02384400 NJ Primary

Addresses

Primary practice location

795 Franklin Ave
Franklin Lakes, NJ 07417-1368

Mailing address

795 Franklin Ave
Franklin Lakes, NJ 07417-1368
Phone (201) 474-3341

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251124003351 NJ Practitioner - Physical Therapist in Private Practice 6002308384 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ivyrehab Network IncGroup PAC ID 3476539776, 658 clinicians

Practice addresses (Care Compare)

333 15TH St
Suite 2B
Hoboken, NJ 07030-3429
Phone (201) 630-8880

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA02384400NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ivyrehab Network, Inc. Physical Therapist CurrentSince Nov 13, 2025 Accepting new patients
Ivyrehab Network Inc. Physical Therapist CurrentSince Nov 13, 2025 Accepting new patients

Locations

731 Lacey Rd
Ste 3
Forked River, NJ 08731
Phone (609) 242-6780

795 Franklin Ave
Franklin Lks, NJ 07417
Phone (201) 639-6620

454 Passaic St
Hackensack, NJ 07601
Phone (201) 488-7905

333 15th St
Ste 2B
Hoboken, NJ 07030
Phone (201) 630-8880

Organizations & group practices 2

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": "1762992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762992000000",
    "number": "1336009315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "795 FRANKLIN AVE",
            "city": "FRANKLIN LAKES",
            "state": "NJ",
            "postal_code": "074171368",
            "telephone_number": "201-474-3341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "795 FRANKLIN AVE",
            "city": "FRANKLIN LAKES",
            "state": "NJ",
            "postal_code": "074171368",
            "telephone_number": "201-474-3341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SQUILLA",
        "first_name": "JAKE",
        "middle_name": "ALEXANDER",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-11-13",
        "last_updated": "2025-11-13",
        "certification_date": "2025-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA02384400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Franklin Lakes, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2025; 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.