Individual provider Active NPI

Jessica Woodard, DPT

  • Physical Therapist
  • Syracuse, NY
National Provider Identifier
1366819443
Registry record updated Nov 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
039006-1 Issued in NY
Practice address
1054 James St
Syracuse, NY 13203-2749
Phone
(315) 422-2912
Fax
(315) 422-3538
NPI assigned
Aug 25, 2015
Last updated
Nov 7, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2017

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 039006-1 NY Primary

Addresses

Primary practice location

1054 James St
Syracuse, NY 13203-2749

Mailing address

1054 James St
Syracuse, NY 13203-2749
Phone (315) 422-2912

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151203002302 NY Practitioner - Physical Therapist in Private Practice 7810297488 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
State University of New York at Buffalo School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Physical Therapy LLCGroup PAC ID 5294702460, 12 clinicians

Practice addresses (Care Compare)

1054 James St
Syracuse, NY 13203-2749
Phone (315) 422-2912

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
039006-1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Physical Therapy LLC Physical Therapist CurrentSince Oct 20, 2015 Accepting new patients

Locations

1054 James St
Syracuse, NY 13203
Phone (315) 422-2912

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": "1440460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510012800000",
    "number": "1366819443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1054 JAMES ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132032749",
            "telephone_number": "315-422-2912",
            "fax_number": "315-422-3538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1054 JAMES ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132032749",
            "telephone_number": "315-422-2912",
            "fax_number": "315-422-3538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODARD",
        "first_name": "JESSICA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-25",
        "last_updated": "2017-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "039006-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2017; 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.