Individual provider Active NPI

Jacqueline Ruggiero, PT,DPT

  • Physical Therapist
  • Holmdel, NJ
National Provider Identifier
1457993784
Registry record updated Oct 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01895400 Issued in NJ
Practice address
2107 Route 35
Holmdel, NJ 07733-2795
Phone
(732) 856-9791
NPI assigned
Oct 8, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2019

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 40QA01895400 NJ Primary

Addresses

Primary practice location

2107 Route 35
Holmdel, NJ 07733-2795

Mailing address

900 Route 9 N Ste 410
Woodbridge, NJ 07095-1003
Phone (201) 801-7141

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191126001170 NJ Practitioner - Physical Therapist in Private Practice 3476986837 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jag-One Physical Therapy LLCGroup PAC ID 2769584325, 334 clinicians

Practice addresses (Care Compare)

2360 Morris Ave
Union, NJ 07083-5707
Phone (908) 206-1700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA01895400NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Home Rehabilitation, LLC Physical Therapist CurrentSince Aug 1, 2021 Accepting new patients
Jag-One Physical Therapy, LLC Physical Therapist CurrentSince Oct 8, 2019 Accepting new patients

Locations

981 US Highway 22
Fl 2
Bridgewater, NJ 08807
Phone (908) 231-0511

2107 State Route 35
Holmdel, NJ 07733
Phone (732) 587-5065

221 Rockingham Row
Princeton, NJ 08540
Phone (609) 580-1520

2360 Morris Ave
Union, NJ 07083
Phone (908) 206-1700

622 Eagle Rock Ave
West Orange, NJ 07052
Phone (973) 669-0078

900 Route 9 N
Ste 410
Woodbridge, NJ 07095

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": "1570492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570492800000",
    "number": "1457993784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 ROUTE 9 N STE 410",
            "city": "WOODBRIDGE",
            "state": "NJ",
            "postal_code": "070951003",
            "telephone_number": "201-801-7141",
            "fax_number": "732-218-5322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2107 ROUTE 35",
            "city": "HOLMDEL",
            "state": "NJ",
            "postal_code": "077332795",
            "telephone_number": "732-856-9791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUGGIERO",
        "first_name": "JACQUELINE",
        "credential": "PT,DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-08",
        "last_updated": "2019-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01895400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holmdel, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2019; 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.