Individual provider Active NPI

Jessica Nicole D'Angelo, DPT

  • Physical Therapist
  • Jackson, NJ
National Provider Identifier
1790397289
Registry record updated Aug 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA01945200 Issued in NJ
Practice address
728 Bennetts Mills Rd
Jackson, NJ 08527-3850
Phone
(732) 415-1401
Fax
(732) 415-1403
NPI assigned
Aug 18, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 18, 2020

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 40QA01945200 NJ Primary

Addresses

Primary practice location

728 Bennetts Mills Rd
Jackson, NJ 08527-3850

Mailing address

5 Swallow Tail CT
Jackson, NJ 08527-2872
Phone (732) 832-1936

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201210001314 NJ Practitioner - Physical Therapist in Private Practice 9931511268 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
72.19 of 100Reported as group
Quality
42.79
Promoting interoperability
95
Improvement activities
40
Cost
68.67

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA01945200NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Spine Care and Physical Rehabilitation,LLC CurrentSince Oct 25, 2020 Accepting new patients
Seaview Orthopaedics & Medical Associates LLP Physical Therapist CurrentSince Feb 1, 2023 Accepting new patients
Seaview Orthopaedics & Medical Associates LLP CurrentSince Feb 1, 2023 Accepting new patients
Spine & Sports Medicine of Freehold, LLC Physical Therapist PastSince Mar 1, 2024 Accepting new patients

Locations

1640 Route 88 W
Brick, NJ 08724
Phone (732) 458-7866

1640 Route 88 W
Brick, NJ 08724
Phone (732) 458-7866

728 Bennetts Mills Rd
Jackson, NJ 08527
Phone (732) 415-1401

728 Bennetts Mills Rd
Ste 1
Jackson, NJ 08527
Phone (732) 415-1401

1200 Eagle Ave
Ocean, NJ 07712

Organizations & group practices 5

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": "1597708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597708800000",
    "number": "1790397289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 SWALLOW TAIL CT",
            "city": "JACKSON",
            "state": "NJ",
            "postal_code": "085272872",
            "telephone_number": "732-832-1936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "728 BENNETTS MILLS RD",
            "city": "JACKSON",
            "state": "NJ",
            "postal_code": "085273850",
            "telephone_number": "732-415-1401",
            "fax_number": "732-415-1403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "D'ANGELO",
        "first_name": "JESSICA",
        "middle_name": "NICOLE",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-18",
        "last_updated": "2020-08-18",
        "certification_date": "2020-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01945200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2020; 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.