Andrew T Jacquay, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

27316 Issued in FL

Practice address

31 Lupi CT
Suite 150
Palm Coast, FL 32137-4761

Phone

(386) 447-0011

NPI assigned

Jul 30, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Florida Luna Care Physical Therapy LLCGroup PAC ID 3779991559, 27 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Florida Luna Care Physical Therapy LLC

  • Physical Therapist
  • Jacksonville, FL
  • NPI 1114542032
  Medicare reassignment Care Compare group
• Almberg Clinics Inc

  • Rehabilitation Clinic/Center
  • Palm Coast, FL
  • NPI 1538137252
  NPD (past)
• University Rehabilitation, LLC

  • Physical Therapist
  • Port Orange, FL
  • NPI 1811185291
  NPD (past)

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

{
    "created_epoch": "1343606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355788800000",
    "number": "1669728499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13401 SUTTON PARK DR S",
            "address_2": "APT #714",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322245266",
            "telephone_number": "859-250-5061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 LUPI CT",
            "address_2": "SUITE 150",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321374761",
            "telephone_number": "386-447-0011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACQUAY",
        "first_name": "ANDREW",
        "middle_name": "T",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-30",
        "last_updated": "2012-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "27316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anita Dionne Jackson
• Donna Kay Jackson
• Jade Jackson, L.D.O
• Jeremy Jackson
• Ronald F Jacob, DDS
• Vijay K Jain, M.D.
• Henry James, N/A
• Samaria S James, RN
• Jane Walter D.P.M., P.a.
• Joseph Lawrence Jardine

• Physical Therapist in Palm Coast, FL
• Providers in Palm Coast, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2012; 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.