Individual provider Active NPI

Jessica Iacona

  • Physical Therapist
  • Piscataway, NJ
National Provider Identifier
1497504336
Registry record updated May 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
1260 Centennial Ave
Piscataway, NJ 08854-4332
Phone
(732) 204-0678
NPI assigned
May 14, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2024

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 Primary

Addresses

Primary practice location

1260 Centennial Ave
Piscataway, NJ 08854-4332

Mailing address

103 Cameo PL
Colonia, NJ 07067-1130

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240709000108 NJ Practitioner - Physical Therapist in Private Practice 3779028337 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
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)

1071 Inman Ave
Unit 4
Edison, NJ 08820-1132
Phone (732) 518-8868

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ivyrehab Network Inc Physical Therapist CurrentSince Aug 1, 2024 Accepting new patients
Ivyrehab Network, Inc. Physical Therapist CurrentSince Aug 1, 2024 Accepting new patients
Ivyrehab Network Inc. Physical Therapist Current Accepting new patients

Locations

1071 Inman Ave
Unit 4
Edison, NJ 08820
Phone (732) 518-8868

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

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

1260 Centennial Ave
Piscataway, NJ 08854
Phone (732) 204-0678

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.

NPI Registry JSON

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

{
    "created_epoch": "1715644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715644800000",
    "number": "1497504336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 CAMEO PL",
            "city": "COLONIA",
            "state": "NJ",
            "postal_code": "070671130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1260 CENTENNIAL AVE",
            "city": "PISCATAWAY",
            "state": "NJ",
            "postal_code": "088544332",
            "telephone_number": "732-204-0678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IACONA",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-14",
        "last_updated": "2024-05-14",
        "certification_date": "2024-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Piscataway, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2024; 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.