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

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