Individual provider Active NPI

Jessica Takacs

  • Physical Therapist
  • Lafayette, NJ
National Provider Identifier
1649727843
Registry record updated Jan 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
042903-1 Issued in NY
Practice address
49 Mulford Rd
Lafayette, NJ 07848-3612
Phone
(862) 268-5800
NPI assigned
Sep 6, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 40QA01686900 NJ
Physical Therapist 225100000X 22701 MA
Physical Therapist 225100000X 042903-1 NY Primary

Addresses

Primary practice location

49 Mulford Rd
Lafayette, NJ 07848-3612

Mailing address

23204 Waters View Cir
Cohoes, NY 12047-5249
Phone (862) 268-5800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
22701MAMDPhysical Therapist
40QA01686900NJMDPhysical Therapist
042903-1NYMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1473120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611532800000",
    "number": "1649727843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23204 WATERS VIEW CIR",
            "city": "COHOES",
            "state": "NY",
            "postal_code": "120475249",
            "telephone_number": "862-268-5800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 MULFORD RD",
            "city": "LAFAYETTE",
            "state": "NJ",
            "postal_code": "078483612",
            "telephone_number": "862-268-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAKACS",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-06",
        "last_updated": "2021-01-25",
        "certification_date": "2021-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01686900",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "22701",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "042903-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.