JAKE T BROCCOLO DPT
NPI 1144709114
Physical Therapist in North Providence, RI
About Jake T Broccolo Dpt NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JAKE T BROCCOLO DPT (NPI 1144709114) is an individual physical therapist in North Providence, Rhode Island, licensed in Rhode Island (PT03093) and active in the NPI registry since August 2018. He maintains a secondary practice location in Seekonk and is a graduate of Other (2018).
NPPES Registry Identity
Specialties & Licenses
- Diagnose and manage movement dysfunction and enhance physical and functional abilities.
- Restore, maintain, and promote not only optimal physical function but optimal wellness and fitness and optimal quality of life as it relates to movement and health.
- Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries.
- Treat conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems.
- Address the negative effects attributable to unique personal and environmental factors as they relate to human performance.
Secondary Practice Location 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Jake T Broccolo Dpt is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
2Medicare enrollment records show Jake Broccolo reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Providence, RI 02906
- Reassigned Medicare billing, Massachusetts and Rhode Island enrollments
- 235 clinicians in this Medicare group
Warwick, RI 02886
- Reassigned Medicare billing, Rhode Island enrollment
- 114 clinicians in this Medicare group
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 5
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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 02904 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
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.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Jake Broccolo's NPI number?
The NPI number for Jake Broccolo is 1144709114. It was assigned to this individual provider in the NPPES registry on August 10, 2018.
Where is Jake Broccolo located?
Jake Broccolo practices at 1401 Douglas Ave, North Providence, RI 02904. The listed phone number is (401) 726-7100.
What is Jake Broccolo's specialty?
The primary specialty registered for this NPI is Physical Therapist with taxonomy code 225100000X.
Is Jake Broccolo enrolled in Medicare?
Yes. Jake Broccolo is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Jake Broccolo's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jake Broccolo reassigns Medicare benefits to 2 organizations: Silver Fern Practice, LLC (Providence, RI) and Elite Physical Therapy, LLC (Warwick, RI). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jake Broccolo's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Jake Broccolo accept?
Health plans from Anthem Blue Cross and Blue Shield list Jake Broccolo as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Jake Broccolo was last updated on January 30, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months 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.
# Jake T Broccolo, DPT · NPI 1144709114
Physical Therapist provider in North Providence, Rhode Island. Individual provider, active in the CMS NPPES registry since August 10, 2018.
## Identity
- **NPI:** 1144709114 (Entity type: Individual)
- **Enumerated:** August 10, 2018
- **Primary specialty:** Physical Therapist · taxonomy 225100000X
- **State license:** PT03093 (Rhode Island)
- **Sole proprietor:** No
## Practice location
- **Address:** 1401 DOUGLAS AVE, North Providence, RI 02904-4058
- **Phone:** (401) 726-7100
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Silver Fern Practice, LLC (NPI 1851472914, Providence, RI); Elite Physical Therapy, LLC (NPI 1225123565, Warwick, RI) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2018
## Record status
- **NPPES last updated:** January 30, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1144709114) · Data from the CMS NPPES public registry.