Individual provider Active NPI

Jessica Puccio, PT, DPT

  • Physical Therapist
  • Brooklyn, NY
National Provider Identifier
1841945664
Registry record updated Feb 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
047637-01 Issued in NY
Practice address
202 Union Ave Ste K
Brooklyn, NY 11211-7467
Phone
(718) 387-7420
Fax
(718) 387-7421
NPI assigned
Feb 21, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2022

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 047637-01 NY Primary

Addresses

Primary practice location

202 Union Ave Ste K
Brooklyn, NY 11211-7467

Mailing address

202 Union Ave Ste K
Brooklyn, NY 11211-7467
Phone (718) 387-7420

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
047637-01NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Brooklyn Body Works Physical Therapy, P.C. Physical Therapist CurrentSince Feb 27, 2022 Accepting new patients
Brooklyn Body Works Physical Therapy - Northside PastSince Feb 27, 2022 Accepting new patients

Locations

202 Union Ave
Ste K
Brooklyn, NY 11211
Phone (718) 387-7420

Organizations & group practices 2

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": "1645401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645401600000",
    "number": "1841945664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 UNION AVE STE K",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112117467",
            "telephone_number": "718-387-7420",
            "fax_number": "718-387-7421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 UNION AVE STE K",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112117467",
            "telephone_number": "718-387-7420",
            "fax_number": "718-387-7421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUCCIO",
        "first_name": "JESSICA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-21",
        "last_updated": "2022-02-21",
        "certification_date": "2022-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "047637-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2022; 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.