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

Jesse Phalanukorn

Individual provider Physical Therapist · NPI 1407455199

Jesse Phalanukorn is a Physical Therapist in Private Practice in Brick, New Jersey. Qualified in 2020, 6 years ago. Practices with Denali Physical Therapy Limited Partnership, a 10-clinician group and accepts Medicare assignment. Licensed in Washington.

Years since qualifying
6
Licensed in
WA
In the registry since
2020
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Practice location Address checks out

489 Brick Blvd
Brick, NJ 08723-6055
Phone: (732) 895-7283
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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 PT61209291 (WA)

Record details

NPI number1407455199
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedOctober 22, 2020
Last updated in NPPESOctober 21, 2021
Certification dateOctober 21, 2021
Mailing address489 Brick Blvd, Brick, NJ 08723-6055

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Denali Physical Therapy Limited Partnership — 10 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Brick