Individual provider Active NPI

Jennifer Rose Demaria

  • Pediatric Occupational Therapist
  • Floral Park, NY
National Provider Identifier
1053997593
Registry record updated Mar 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
023795 Issued in NY
Practice address
8217 255TH St
Floral Park, NY 11004-1410
Phone
(718) 775-5894
NPI assigned
Mar 23, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 023795 NY Primary

Addresses

Primary practice location

8217 255TH St
Floral Park, NY 11004-1410

Mailing address

8217 255TH St
Floral Park, NY 11004-1410
Phone (718) 775-5894

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
023795NYMDPediatric Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1616457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616457600000",
    "number": "1053997593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8217 255TH ST",
            "city": "FLORAL PARK",
            "state": "NY",
            "postal_code": "110041410",
            "telephone_number": "718-775-5894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8217 255TH ST",
            "city": "FLORAL PARK",
            "state": "NY",
            "postal_code": "110041410",
            "telephone_number": "718-775-5894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMARIA",
        "first_name": "JENNIFER",
        "middle_name": "ROSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-23",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NY",
            "license": "023795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Floral Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2021; 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.