Individual provider Active NPI

Jennifer Murray Buonocore, MS, OTR/L

  • Contractor
  • Long Beach, NY
National Provider Identifier
1063666865
Registry record updated Jun 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ContractorTaxonomy code 171W00000X
License
011735-1 Issued in NY
Practice address
310 National Blvd
Long Beach, NY 11561-3326
Phone
(516) 431-2929
Fax
(516) 431-6278
NPI assigned
Nov 6, 2008
Last updated
Jun 13, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X 011735-1 NY Primary

Addresses

Primary practice location

310 National Blvd
Long Beach, NY 11561-3326

Mailing address

1259 Mara CT
Atlantic Beach, NY 11509-1635
Phone (516) 431-1688

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)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
011735-1NYMDPediatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Barry & Florence Friedberg JCC Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1225929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339545600000",
    "number": "1063666865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1259 MARA CT",
            "city": "ATLANTIC BEACH",
            "state": "NY",
            "postal_code": "115091635",
            "telephone_number": "516-431-1688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 NATIONAL BLVD",
            "city": "LONG BEACH",
            "state": "NY",
            "postal_code": "115613326",
            "telephone_number": "516-431-2929",
            "fax_number": "516-431-6278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUONOCORE",
        "first_name": "JENNIFER",
        "middle_name": "MURRAY",
        "name_prefix": "Mrs.",
        "credential": "MS, OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-11-06",
        "last_updated": "2012-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "NY",
            "license": "011735-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2012; 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.