Individual provider Active NPI

Peggy Ciriello, MSPT

  • Physical Therapist
  • West Orange, NJ
National Provider Identifier
1962553537
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA00455500 Issued in NJ
Practice address
622 Eagle Rock Ave
West Orange, NJ 07052-2994
Phone
(973) 669-0078
Fax
(973) 669-1113
NPI assigned
Jan 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 40QA00455500 NJ Primary

Addresses

Primary practice location

622 Eagle Rock Ave
West Orange, NJ 07052-2994

Mailing address

5 Academy Rd
Madison, NJ 07940-2001
Phone (973) 669-0078

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070305000006 NJ Practitioner - Physical Therapist in Private Practice 5193827558 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jag-One Physical Therapy LLCGroup PAC ID 2769584325, 334 clinicians

Practice addresses (Care Compare)

622 Eagle Rock Ave
West Orange, NJ 07052-2994
Phone (973) 669-0078

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Jag-One Physical Therapy, LLC Physical Therapist CurrentSince Jan 24, 2007 Accepting new patients

Locations

981 US Highway 22
Fl 2
Bridgewater, NJ 08807
Phone (908) 231-0511

221 Rockingham Row
Princeton, NJ 08540
Phone (609) 580-1520

622 Eagle Rock Ave
West Orange, NJ 07052
Phone (973) 669-0078

Organizations & group practices 1

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": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962553537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 ACADEMY RD",
            "city": "MADISON",
            "state": "NJ",
            "postal_code": "079402001",
            "telephone_number": "973-669-0078",
            "fax_number": "973-669-1113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 EAGLE ROCK AVE",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070522994",
            "telephone_number": "973-669-0078",
            "fax_number": "973-669-1113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIRIELLO",
        "first_name": "PEGGY",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA00455500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Orange, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.