Jacqueline Grant, DPT
Individual provider Active NPI Physical Therapist · Stony Point, NY
NPI 1922839802 · NPPES record last updated Aug 12, 2024
Key facts
- NPI
- 1922839802
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 052702 (NY)
- Practice address
- 25 Liberty Square Mall
Stony Point, NY 10980-2400 - Phone
- (845) 738-7383
- NPI assigned
- Aug 12, 2024
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 18
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2024
- Medicare assignment
- May accept Medicare assignment
- Telehealth
- Offers telehealth services
- Group practices
- Montefiore Medical Center
Practice addresses (Care Compare)
25 Liberty Square Mall
Stony Point, NY 10980-2400
Phone (845) 738-7383
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240903001356 | NY | Practitioner - Physical Therapist in Private Practice | 0547709644 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles (3 of 7)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Montefiore Medical Center | Current |
Accepting new patients | |
| Montefiore Medical Center | Current |
Accepting new patients | |
| Access PT, OT, New York, PLLC | Physical Therapist | Current |
Accepting new patients |
Locations
111 E 210th St
Bronx, NY 10467
16 Maybrook Rd
Ste L
Campbell Hall, NY 10916
111 Maiden Ln
Kingston, NY 12401
Phone (845) 331-8590
785 State Route 17M
Ste 16
Monroe, NY 10950
Phone (845) 782-3200
25 Liberty Square Mall
Stony Point, NY 10980
Phone (845) 356-2900
Networks
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H5989
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 052702 | NY | Yes |
Addresses
Primary practice location
25 Liberty Square Mall
Stony Point, NY 10980-2400
Mailing address
8 Ashlawn CT
Spring Valley, NY 10977-1329
Other providers in Stony Point, NY
- Gayatri S Samnarain
- Emmanuela Gedeon
- Genovese Drug Stores Inc
- Gerard Salomon MD PC
- Usha I Goohya
- Lawrence Allen Greenman
- Neena Grewal
- Perminder S Grewal
- Carol Guarino
- Margaret Murdoch Hagerty
All providers in Stony Point, NY · Physical Therapist in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 12, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.