Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Jack Annunziato, DO

Individual provider Neuromusculoskeletal Medicine & OMM Physician · NPI 1821478744

Dr. Jack Annunziato, DO is a Plastic and Reconstructive Surgery in Ridgewood, New Jersey. Graduated from Rowan University School of Osteopathic Medicine in 2015, 11 years ago. Practices with Valley Physician Services PC, a 592-clinician group, accepts Medicare assignment and offers telehealth. Licensed in New Jersey and Pennsylvania.

Years since qualifying
11
Trained at
Rowan University School of Osteopathic Medicine
Licensed in
NJ, PA
In the registry since
2015
Specialties on file
3
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

See every abbreviation used in this directory →

Practice location Address checks out

1200 E Ridgewood Ave Ste 306
Ridgewood, NJ 07450-3937
Phone: (201) 612-4857
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Medicine & Rehabilitation Physician (primary) Taxonomy 208100000X · Licence 25MB10536200 (NJ)
Neuromusculoskeletal Medicine & OMM Physician Taxonomy 204D00000X · Licence 25MB10536200 (NJ)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X · Licence OT016359 (PA)

Record details

NPI number1821478744
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedJune 5, 2015
Last updated in NPPESApril 28, 2021
Certification dateApril 28, 2021
Mailing address1200 E Ridgewood Ave Ste 306, Ridgewood, NJ 07450-3937

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPLASTIC AND RECONSTRUCTIVE SURGERY
Medical schoolROWAN UNIVERSITY SCHOOL OF OSTEOPATHIC MEDICINE
Graduated 2015 (11 years in practice)
Group practice Valley Physician Services Pc — 592 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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