Active NPI
Jacqueline R. Exley, DPT
- Physical Therapist
- Erie, PA
National Provider Identifier
1841553641
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(1) exclusion effective Jun 18, 2026.
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT022060
- Practice address
- 902 West Erie Plaza Dr.
Erie, PA 16505-4536 - Phone
- (814) 456-6000
- Fax
- (814) 456-6060
- NPI assigned
- Jun 18, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | |||
| Physical Therapist | 225100000X | PT022060 | PA | Primary |
Addresses
Primary practice location
902 West Erie Plaza Dr.
Erie, PA 16505-4536
Mailing address
902 West Erie Plaza Dr.
Erie, PA 16505-4536
Phone (814) 456-6000
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 002708901 | Other | PA | BS |
| 1027700880001 | Medicaid | PA |
Other names 1
- Ms. Jacqueline R. Bacco
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1339977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1451952000000",
"number": "1841553641",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "902 WEST ERIE PLAZA DR.",
"city": "ERIE",
"state": "PA",
"postal_code": "165054536",
"telephone_number": "814-456-6000",
"fax_number": "814-456-6060"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "902 WEST ERIE PLAZA DR.",
"city": "ERIE",
"state": "PA",
"postal_code": "165054536",
"telephone_number": "814-456-6000",
"fax_number": "814-456-6060"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EXLEY",
"first_name": "JACQUELINE",
"middle_name": "R.",
"name_prefix": "Mrs.",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-06-18",
"last_updated": "2016-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PA",
"license": "PT022060",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BS",
"identifier": "002708901",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1027700880001",
"state": "PA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "JACQUELINE",
"last_name": "BACCO",
"middle_name": "R.",
"prefix": "MS.",
"credential": "DPT",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Erie, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.