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

Vincent Gary Petracco, DPT

Individual provider Physical Therapist · NPI 1619487444

Vincent Gary Petracco, DPT is a Physical Therapist in Private Practice in Wall Township, New Jersey. Qualified in 2017, 9 years ago. Practices with Jag-One Physical Therapy LLC, a 328-clinician group and accepts Medicare assignment. Licensed in New Jersey.

Years since qualifying
9
Licensed in
NJ
In the registry since
2017
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

4810 Belmar Blvd
Wall Township, NJ 07753-6952
Phone: (732) 938-5333
Fax: (732) 938-5680
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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 40QA01741300 (NJ)

Record details

NPI number1619487444
Entity typeIndividual (Type 1)
GenderMale
Credentials DPT
Sole proprietorNo
NPI enumeratedOctober 6, 2017
Last updated in NPPESFebruary 7, 2020
Certification dateFebruary 7, 2020

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Jag-One Physical Therapy Llc — 328 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Wall Township