Jaclyn Nanna, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

042441 Issued in NY

Practice address

1367 Washington Ave Ste 100
Albany, NY 12206

Phone

(518) 438-7926

Fax

(518) 438-8364

NPI assigned

Nov 9, 2017

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Resolute Physical Therapy PLLCGroup PAC ID 8022491539, 4 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 and National Provider Directory roles.

• Resolute Physical Therapy PLLC

  • Physical Therapy Clinic/Center
  • Halfmoon, NY
  • NPI 1699404889

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Nicolla and Associates, PT & OT Services, PLLC

  • Specialist
  • Latham, NY
  • NPI 1487633152

  Physical Therapist

  Medicare reassignment NPD
• Thomas Nicolla Consulting Services, PLLC

  • Physical Therapist
  • Stamford, NY
  • NPI 1770636060
  NPD
• Capital Area Physical Therapy, PLLC

  • Physical Therapy Clinic/Center
  • Malta, NY
  • NPI 1477995330
  NPD (past)

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

{
    "created_epoch": "1510185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527552000000",
    "number": "1942713144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 TROY SCHENECTADY RD STE 209",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102461",
            "telephone_number": "518-786-1667",
            "fax_number": "518-786-1954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1367 WASHINGTON AVE STE 100",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "12206",
            "telephone_number": "518-438-7926",
            "fax_number": "518-438-8364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NANNA",
        "first_name": "JACLYN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-09",
        "last_updated": "2018-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "042441",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05072615",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "J400428220",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kyle Nameth, MD
• Lauren Grace Namkoong, MD
• Peter Namkoong, M.D.
• Nancy Davison
• Nancy Trzcinski, Nurse Practitioner in Adult Health & Family Health PL
• Nathan Naparstek, PHD
• Mark B Napier, M.D.
• Danielle Rhea Napieralski, PA
• Anne Fitzgerald Napolitano
• Ananth Vishwanath Narayan, M.D.

• Physical Therapist in Albany, NY
• Providers in Albany, 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 May 29, 2018; 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.