Individual provider Active NPI

Jennifer Dawn Bailey, MS OTR/L

  • Pediatric Occupational Therapist
  • Syracuse, NY
National Provider Identifier
1093097479
Registry record updated Sep 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
016191-1 Issued in NY
Practice address
171 Intrepid LN
Syracuse, NY 13205-2548
Phone
(315) 437-4689
NPI assigned
Sep 12, 2011
Last updated
Sep 12, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2011

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 016191-1 NY Primary

Addresses

Primary practice location

171 Intrepid LN
Syracuse, NY 13205-2548

Mailing address

243 N Main St Apt 1
Oneida, NY 13421-1319
Phone (315) 292-8428

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150226002049 NY Practitioner - Occupational Therapist in Private Practice 1658697123 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nysarc Inc.Group PAC ID 6608869193, 15 clinicians

Practice addresses (Care Compare)

701 Lenox Ave
Oneida, NY 13421-1500
Phone (315) 363-9281

719 Lenox Ave
Oneida, NY 13421-1500
Phone (315) 363-9281

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
016191-1NYMDPediatric Occupational Therapist
016191NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Nysarc Inc. CurrentSince Nov 7, 2013 Accepting new patients
The Network for Children's Speech, Occupational and Physical Therapy Past Accepting new patients

Locations

634 Birchwood Dr
Oneida, NY 13421

701 Lenox Ave
Oneida, NY 13421
Phone (315) 363-3389

719 Lenox Ave
Oneida, NY 13421

Organizations & group practices 2

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": "1315785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315785600000",
    "number": "1093097479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "243 N MAIN ST APT 1",
            "city": "ONEIDA",
            "state": "NY",
            "postal_code": "134211319",
            "telephone_number": "315-292-8428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 INTREPID LN",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132052548",
            "telephone_number": "315-437-4689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILEY",
        "first_name": "JENNIFER",
        "middle_name": "DAWN",
        "credential": "MS OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-12",
        "last_updated": "2011-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NY",
            "license": "016191-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.