Jenna Crocilla, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

047716 Issued in NY

Practice address

328 E State St
Herkimer, NY 13350-2026

Phone

(315) 794-8530

NPI assigned

Oct 25, 2021

Last updated

Nov 19, 2024By the provider in NPPES

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

Specialty

Physical Therapist in Private Practice

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jonathan T Small Physical Therapy PLLCGroup PAC ID 9436428166, 2 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.

• Jonathan T Small Physical Therapy PLLC

  • Physical Therapist
  • Herkimer, NY
  • NPI 1861928020
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1635120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1922762145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "328 E STATE ST",
            "city": "HERKIMER",
            "state": "NY",
            "postal_code": "133502026",
            "telephone_number": "315-794-8530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "328 E STATE ST",
            "city": "HERKIMER",
            "state": "NY",
            "postal_code": "133502026",
            "telephone_number": "315-794-8530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROCILLA",
        "first_name": "JENNA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-25",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "047716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Colleen Conway-Edwards, AGPCNP
• Lauren Conway
• Cornerstone Herkimer
• Nicole Marie Cosar
• Jessica M Crannell, MPT
• Crystal Clear Nutrition, PLLC
• Andre F Cuda, LMSW
• Tina Cumm, LPN
• Daniel N Curri, DPT
• Lori A Currier, LMSW

• Physical Therapist in Herkimer, NY
• Providers in Herkimer, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2024; 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.