Jaclyn A Gamache, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

040.0121765 Issued in VT

Practice address

1 Scale Ave
Building 18, Suite 32
Rutland, VT 05701-4452

Phone

(802) 855-8068

Fax

(802) 855-8436

NPI assigned

Aug 1, 2016

Last updated

Aug 1, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VT

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

University of Vermont College of Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Rehabgym IncGroup PAC ID 5092619411, 23 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• The Rehabgym Inc

  • Physical Therapist
  • Williston, VT
  • NPI 1750421772
  Medicare reassignment Care Compare group NPD
• Back on Track Physical Therapy PLLC

  • Physical Therapist
  • Rutland, VT
  • NPI 1871885913
  Medicare reassignment NPD

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

{
    "created_epoch": "1470009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470009600000",
    "number": "1831642396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "794 HITCHCOCK RD",
            "city": "PITTSFORD",
            "state": "VT",
            "postal_code": "057639544",
            "telephone_number": "207-632-4030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SCALE AVE",
            "address_2": "BUILDING 18, SUITE 32",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "057014452",
            "telephone_number": "802-855-8068",
            "fax_number": "802-855-8436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMACHE",
        "first_name": "JACLYN",
        "middle_name": "A",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-01",
        "last_updated": "2016-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VT",
            "license": "040.0121765",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH PROVIDER ID",
            "identifier": "13865603",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joseph Gabcik
• Marcia Gadway
• Paula Gagnon, NP-C
• Margaret Gallagher
• Jared Galster, D.C.
• Matthew Gammons, M.D.
• John Joseph Garbecki
• Karen Gail Gartner, PT, PCS, ATP
• Kaitlyn Ann Gawet-Karpak, MSW, LICSW
• Nina Elaine Gee, LAC

• Physical Therapist in Rutland, VT
• Providers in Rutland, VT by specialty
• Physical Therapist in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2016; 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.