Jennifer Anne Tiseo, MA, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

0155221 Issued in NY

Practice address

1428 5TH Ave
Bay Shore, NY 11706-4147

Phone

(631) 665-1900

NPI assigned

Feb 12, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Acld Kramer Learning Center

  • Developmental Disabilities Clinic/Center
  • Bay Shore, NY
  • NPI 1942565015
  NPD (past)
• Adults and Children With Learning and Developmental Disabilites, Inc.

  • Developmental Disabilities Clinic/Center
  • Bethpage, NY
  • NPI 1265674303
  NPD (past)
• Island Therapies of Suffolk, LLP

  • Speech-Language Pathologist
  • Deer Park, NY
  • NPI 1770624991

  Physical Therapist

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726185600000",
    "number": "1013058965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 SUMMIT DR",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117875151",
            "telephone_number": "631-724-4643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1428 5TH AVE",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117064147",
            "telephone_number": "631-665-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TISEO",
        "first_name": "JENNIFER",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "MA, PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-12",
        "last_updated": "2024-09-13",
        "certification_date": "2024-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "0155221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jannine Marie Thorp, RPA-C
• Smitha Mary Thotam, NP
• Heather Tier, MD
• Matthew Trevor Tiffany, M.D.
• Alex Tischler
• Alyssa Tkacz
• Alexa Toby
• Nancy C Todd, LCSW
• Humberto Toledo, L.AC.
• John R Tomasula, MD

• Physical Therapist in Bay Shore, NY
• Providers in Bay Shore, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.