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

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



Healthcare Provider's Profile

Full NameJake T Broccolo
GenderMale
SpecialityPhysical Therapy
Experience6 Years
Location1401 Douglas Ave, North Providence, Rhode Island
Accepts Medicare AssignmentsYes. 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.
IdentifierTypeStateIssuer
1144709114NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
225100000XPhysical Therapist PT03093 (Rhode Island)Primary

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Silver Fern Practice Llc1658266515120

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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 NameElite Physical Therapy Llc
Provider TypePart B Supplier - Clinic/group Practice
Provider IdentifiersNPI Number: 1225123565
PECOS PAC ID: 1951295187
Enrollment ID: O20040210000311

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Provider NameSilver Fern Practice Llc
Provider TypePart B Supplier - Physical/occupational Therapy Group In Private Practice
Provider IdentifiersNPI Number: 1851472914
PECOS PAC ID: 1658266515
Enrollment ID: O20120813000580

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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 AddressPractice 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

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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    

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