JACK ANTHONY SPATAFORE DPT/MS
NPI 1093711657
Specialist in Bridgeport, WV

Q: What is Jack Spatafore's NPI number?

The NPI number for Jack Spatafore is 1093711657. It was assigned to this individual provider in the NPPES registry on June 28, 2005.

Q: What is Jack Spatafore's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Q: When was this NPI record last updated?

The NPPES record for Jack Spatafore was last updated on March 25, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 28, 2005

306 W MAIN ST, BRIDGEPORT, WV 26330(304) 842-3137(304) 842-3138 Get Directions Write a Review

NPPES record last updated: March 25, 2009. Verified against the NPPES registry weekly; last sync: November 01, 2026.

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About Jack Anthony Spatafore Dpt/ms NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACK ANTHONY SPATAFORE DPT/MS (NPI 1093711657) is an individual specialist in Bridgeport, West Virginia, licensed in West Virginia (002038) and active in the NPI registry since June 2005. He is a graduate of Other (2000).

NPPES Registry Identity

NPI1093711657

Entity TypeIndividualMale

Primary Taxonomy174400000X

Provider Legal NameJACK ANTHONY SPATAFORECredential: DPT/MS

Location Address306 W MAIN STBridgeport, WV 26330-1751

Mailing Address306 W Main StBridgeport, WV 26330-1751 · (304) 842-3137 · Fax (304) 842-3138

Phone(304) 842-3137

Fax(304) 842-3138

Sole ProprietorNo

Medical School CMSOtherGraduated 2000

Enumeration DateJune 28, 2005

Last NPPES UpdateMarch 25, 2009

✔ NPI 1093711657 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySpecialistOther Service Providers

Taxonomy Code174400000X

License✔ Licensed in WV · 002038

Definition

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Also ListedPhysical TherapistTaxonomy 225100000X · License 002038 (WV)

306 W MAIN ST, Bridgeport, WV 26330

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Other Identifiers 11

Other1382862WV · Umwa

Medicare PINSP4028274WV

Other010718731004WV · Blue Cross

OtherWV51916BWV · Health Plan

Other01071873100WV · Wv Workers' Compensation

Other135810WV · Health Assurance

Other701615WV · Aetna

Medicaid7305012-001WV

Other398789WV · Optimum Choice

Medicare PINSP40282736WV

Other650023875WV · Railroad Medicare

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jack Anthony Spatafore Dpt/ms is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8123056306

PECOS Enrollment IDI20090312000080

Medicare Billing Reassignment

Medicare enrollment records show Jack Spatafore reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Bridgeport Physical Therapy Services, Inc.

0.7 mi

Specialist

306 W MAIN ST
Bridgeport, WV 26330

Reassigned Medicare billing, West Virginia enrollment
11 clinicians in this Medicare group

NPI 1912086158 (304) 842-3137

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 6

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Therapy procedure using manual technique, each 15 minutes 97140

This therapy involves using hands-on techniques to help improve your body's movement and function. These techniques may include stretching, resistance exercises, or gentle pressure. Each session lasts 15 minutes and aims to relieve pain, promote healing, and improve your overall health.

587 services52 patients

Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes 97110

This therapy involves exercises to boost strength, endurance, flexibility, and range of motion. Each session lasts 15 minutes. The goal is to improve physical function and overall health. It's a safe, beneficial method for enhancing well-being and fitness.

459 services52 patients

Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes 97112

This therapy helps retrain your brain, nerves, and muscles to work together. Through targeted exercises, your body learns to regain lost functions or improve current abilities. Each session lasts 15 minutes.

248 services34 patients

Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care G0283

Electrical stimulation is a therapy method where mild electrical pulses are used to treat pain or stimulate muscles in certain areas. It's not for wound care but is part of a broader therapy plan. It's safe, non-invasive, and can help improve overall health.

238 services41 patients

Therapy procedure using functional activities 97530

A therapy procedure using functional activities encourages you to use your own body movements in day-to-day tasks to aid recovery. It aims to improve your mobility, strength, and overall health by incorporating therapeutic exercises into your routine.

171 services32 patients

Evaluation for physical therapy, typically 20 minutes 97161

An evaluation for physical therapy is a short, 20-minute assessment where your physical condition, mobility, and pain levels are examined. This helps in designing a personalized therapy plan to enhance your physical function and well-being.

58 services39 patients

Other Providers at the Same Location NPPES 17

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. LAWREN ELIZABETH SANDY MPT

Physical Therapist