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

Jason Intermesoli

Individual provider Physical Therapist · NPI 1912736190

Jason Intermesoli is a Physical Therapist in Private Practice in Patchogue, New York. Qualified in 2024, 2 years ago. Practices with New York University, a 5,884-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
2
Licensed in
NY
In the registry since
2024
Specialties on file
2
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Practice location Address checks out

322 W Main St
Patchogue, NY 11772-3008
Phone: (631) 228-4977
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 054022 (NY)
Orthopedic Physical Therapist Taxonomy 2251X0800X · Licence 054022 (NY)

Record details

NPI number1912736190
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJuly 29, 2024
Last updated in NPPESMay 28, 2026
Certification dateMay 28, 2026
Mailing address322 W Main St, Patchogue, NY 11772-3008

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice New York University — 5884 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Patchogue