Deborah R Jacques, DPT

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

P84258 Issued in NY

Practice address

68 Main St
Camillus, NY 13031

Phone

(315) 744-5145

NPI assigned

Jun 14, 2012

Sex

Female

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 NY

Enrollment records 1

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 and National Provider Directory roles.

• Crawford Physical Therapy PLLC

  • Physical Therapist
  • Solvay, NY
  • NPI 1184441123

  NY

  Medicare reassignment NPD
• Otter Creek Medical Office, LLP

  • Family Medicine Physician
  • MC Graw, NY
  • NPI 1164478293
  NPD

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

{
    "created_epoch": "1339632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538524800000",
    "number": "1902168941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2024 CANAL RD",
            "city": "MEMPHIS",
            "state": "NY",
            "postal_code": "131129799",
            "telephone_number": "315-744-5145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "68 MAIN ST",
            "city": "CAMILLUS",
            "state": "NY",
            "postal_code": "13031",
            "telephone_number": "315-744-5145"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "813 Fay Rd",
            "address_purpose": "LOCATION",
            "city": "Syracuse",
            "state": "NY",
            "postal_code": "132193009",
            "country_code": "US",
            "telephone_number": "315-703-0874",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACQUES",
        "first_name": "DEBORAH",
        "middle_name": "R",
        "name_prefix": "Ms.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-14",
        "last_updated": "2018-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "P84258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Immediate Medical Care Associates, PLLC
• Inclusive Mental Health Counseling Services ,PLLC
• Claire Isaacson
• Shannon Lee Isbell, RN
• Leland Jay Jackson, MD
• Kaitlyn Marie Jaeger
• Rachel Janette Jendrowski
• Denise Michelle Johnson, OTR
• Joseph F Finelli, Jr., D.D.S. P.C.
• K Johnson MD

• All providers in Camillus, NY
• Physical Medicine & Rehabilitation Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.