Jake T Broccolo, DPT in North Providence, RI - Medicare Physical Therapy Provider

Jake T Broccolo, DPT is a medicare enrolled "Physical Therapist" provider in North Providence, Rhode Island. He graduated from medical school in 2018 and has 6 years of diverse experience with area of expertise as Physical Therapy. He is a member of the group practice Silver Fern Practice Llc and his current practice location is 1401 Douglas Ave, North Providence, Rhode Island. You can reach out to his office (for appointments etc.) via phone at (401) 726-7100.

Jake T Broccolo is licensed to practice in Rhode Island (license number PT03093) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1144709114.

Contact Information

	Jake T Broccolo, DPT
	1401 Douglas Ave, North Providence, RI 02904-4058
	(401) 726-7100
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Jake T Broccolo
Gender	Male
Speciality	Physical Therapy
Experience	6 Years
Location	1401 Douglas Ave, North Providence, Rhode Island
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Jake T Broccolo graduated from medical school in 2018

NPI Data:

NPI Number: 1144709114
Provider Enumeration Date: 08/10/2018
Last Update Date: 11/03/2023

Medicare PECOS Information:

PECOS PAC ID: 9032452610
Enrollment ID: I20190522002292

Medical Identifiers

Medical identifiers for Jake T Broccolo such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1144709114	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
225100000X	Physical Therapist	PT03093 (Rhode Island)	Primary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Silver Fern Practice Llc	1658266515	124

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Jake T Broccolo allows following entities to bill medicare on his behalf.

Provider Name	Elite Physical Therapy Llc
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1225123565 PECOS PAC ID: 1951295187 Enrollment ID: O20040210000311

Provider Name	Silver Fern Practice Llc
Provider Type	Part B Supplier - Physical/occupational Therapy Group In Private Practice
Provider Identifiers	NPI Number: 1851472914 PECOS PAC ID: 1658266515 Enrollment ID: O20120813000580

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jake T Broccolo is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Jake T Broccolo, DPT 4 Richmond Sq Ste 200, Providence, RI 02906-5117 Ph: (401) 433-4172	Jake T Broccolo, DPT 1401 Douglas Ave, North Providence, RI 02904-4058 Ph: (401) 726-7100

Reviews and Comments

Physical Therapist in North Providence, RI

Rayne Gene Smyth, P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 7 Ivan St, North Providence, RI 02904 Phone: 401-725-8400
Jennifer Teresa Scuncio, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1401 Douglas Ave, North Providence, RI 02904 Phone: 401-435-4540 Fax: 401-434-4521
Lauren Weil, DPT, OCS Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1525 Smith St Ste 5, North Providence, RI 02911 Phone: 401-353-8884
Dr. Paul Anthony Volpe Jr., DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1525 Smith St, Unit 5, North Providence, RI 02911 Phone: 401-353-8884
Renew Physical Therapy & Wellness Studio Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1630 Mineral Spring Ave Ste 6-7, North Providence, RI 02904 Phone: 401-400-5282
Molly Elizabeth Smith, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1405 Douglas Ave, North Providence, RI 02904 Phone: 401-435-4540

Jake T Broccolo, DPT - Medicare Physical Therapist in North Providence, RI