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

Marisa Petrone Gough, PT

Individual provider Physical Therapist · NPI 1871840645

Marisa Petrone Gough, PT is a Physical Therapist in Private Practice in Wayne, New Jersey. Graduated from Rutgers School of Dental Medicine in 2012, 14 years ago. Practices with Jag-One Physical Therapy LLC, a 328-clinician group and accepts Medicare assignment. Licensed in New Jersey.

Years since qualifying
14
Trained at
Rutgers School of Dental Medicine
Licensed in
NJ
In the registry since
2012
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.

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Practice location Address checks out

450 Hamburg Tpke
Wayne, NJ 07470-8480
Phone: (973) 706-7620
Fax: (973) 706-7619
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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 40QA01450400 (NJ)

Record details

NPI number1871840645
Entity typeIndividual (Type 1)
GenderFemale
Credentials PT
Sole proprietorYes
NPI enumeratedAugust 10, 2012
Last updated in NPPESJune 4, 2026
Certification dateJune 4, 2026

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolRUTGERS SCHOOL OF DENTAL MEDICINE
Graduated 2012 (14 years in practice)
Group practice Jag-One Physical Therapy Llc — 328 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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