ANTHONY JACARUSO – Physical Therapist, NPI 1124394770

ANTHONY JACARUSO is a healthcare provider. based in Johnson city, Tennessee. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold a License No. 018884-1 (NY). The NPI Number for ANTHONY JACARUSO is 1124394770

Main info

Male
Sole Proprietor
29 Years Of Experience
Accepts Medicare Assignment
Name
ANTHONY JACARUSO
NPI
1124394770
Phone
(917) 853-9763
Address
296 JESSICAS WAY
Enumeration Date
28 March 2012
Last Update Date
13 March 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4234771101
Graduation Year
1997 (29 years ago)
PAC ID
2961938246
Group Practice PAC ID
2567644289
Professional Enrollment ID
I20241210002758
Address ID
TN376152245GR406XXRDXX401
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience61
Completeness75
Years active:14State licenses:2Digital endpointsOther names

8,787 PHYSICAL THERAPIST IN PRIVATE PRACTICE in NY

Provider Addresses for ANTHONY JACARUSO

  • 296 JESSICAS WAY

    JOHNSON CITY, TN 376153079

    Phone: (917) 853-9763

    Type: Mailing

  • 6102 98TH ST

    REGO PARK, NY 113741515

    Phone: (718) 592-0300

    Type: Mailing

  • 406 ROY MARTIN RD STE 9

    GRAY, TN 376152245

    Phone: (423) 477-1101

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-12-10

PECOS data refreshed: 2026-06-15

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20241210002758IPhysical Therapist In Private PracticeTNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 37615)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2567644289View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeTN
-TN
Physical Therapist In Private PracticeTN
Physical Therapist In Private PracticeTN
-TN
Physical Therapist In Private PracticeTN

Reviews

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Frequently asked questions

Can I cross-check ANTHONY JACARUSO using NPI 1124394770?
NPI 1124394770 belongs to ANTHONY JACARUSO; compare other details if you need extra assurance.
Is ANTHONY JACARUSO still an active registrant?
ANTHONY JACARUSO carries an active NPI according to the public dataset.
How would a patient describe ANTHONY JACARUSO's focus?
For ANTHONY JACARUSO, the primary taxonomy reads as Physical Therapist. Clinical services aligned with this taxonomy classification.
Where in Tennessee is ANTHONY JACARUSO registered?
Use Johnson City, Tennessee as the headline location for ANTHONY JACARUSO here.
Can I trust this NPI listing for ANTHONY JACARUSO?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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