Jared Ivankovic-Macgibbon
NPI 1154043784ActiveIndividual· Physical Therapist· Dedham, MA
Physical Therapist in Dedham, Massachusetts, licensed in MA, with an NPI issued in September 2022. Medicare paid $25,282 for services to 19 patients in 2024.
Overview
| NPI | 1154043784 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | No |
| NPI issued | Sep 12, 2022 |
| Last updated in NPPES | Sep 12, 2022 |
| Certified by provider | Sep 12, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | 26304 | MA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 19 |
|---|---|
| Services billed | 1,167 across 7 procedure codes |
| Paid by Medicare | $25,282 |
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All 87 physical therapists in Dedham · All physical therapists in Massachusetts