Individual provider Active NPI

Joel Jezequel, DPT

  • Physical Therapist
  • New York, NY
National Provider Identifier
1962814467
Registry record updated Mar 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
037950 Issued in NY
Practice address
37 Union SQ W
3Rd Floor
New York, NY 10003-3217
Phone
(212) 750-1110
NPI assigned
Jun 2, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2021

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 037950 NY Primary

Addresses

Primary practice location

37 Union SQ W
3Rd Floor
New York, NY 10003-3217

Mailing address

211 S Narcissus Ave
Mu-1
West Palm Beach, FL 33401
Phone (561) 790-8256

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210422001258 FL Practitioner - Physical Therapist in Private Practice 0446549612 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
S2 Physical Therapy P.a.Group PAC ID 9830426055, 9 clinicians

Practice addresses (Care Compare)

211 S Narcissus Ave
Mu 1
West Palm Beach, FL 33401-5654
Phone (561) 790-8256

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
S2 Physical Therapy P.a. Physical Therapist CurrentSince Apr 1, 2021 Accepting new patients

Locations

211 S Narcissus Ave
Apt 1
West Palm Beach, FL 33401
Phone (561) 790-8256

1 Bridge St
Ste 71
Irvington, NY 10533
Phone (914) 375-3434

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": "1401667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617062400000",
    "number": "1962814467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 S NARCISSUS AVE",
            "address_2": "MU-1",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "33401",
            "telephone_number": "561-790-8256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 UNION SQ W",
            "address_2": "3RD FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100033217",
            "telephone_number": "212-750-1110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEZEQUEL",
        "first_name": "JOEL",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-02",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "037950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2021; 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.