Individual provider Active NPI

Jessica Lee Piatak, OTR/L

  • Occupational Therapist
  • Harris, NY
National Provider Identifier
1124274550
Registry record updated Dec 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
010781-1 Issued in NY
Practice address
840 Benmosche Road
The Center for Discovery
Harris, NY 12742
Phone
(845) 794-1400
Fax
(845) 794-8909
NPI assigned
Aug 18, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OC008366 PA
Occupational Therapist 225X00000X 010781-1 NY Primary

Addresses

Primary practice location

840 Benmosche Road
The Center for Discovery
Harris, NY 12742

Mailing address

840 Benmosche Road
Harris, NY 12742
Phone (845) 794-1400

Other names 1

  • Jessica Lee Tezyk Former name

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
010781-1NYMDOccupational Therapist

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678

NPI Registry JSON

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

{
    "created_epoch": "1219017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323216000000",
    "number": "1124274550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 BENMOSCHE ROAD",
            "city": "HARRIS",
            "state": "NY",
            "postal_code": "12742",
            "telephone_number": "845-794-1400",
            "fax_number": "845-794-8909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 BENMOSCHE ROAD",
            "address_2": "THE CENTER FOR DISCOVERY",
            "city": "HARRIS",
            "state": "NY",
            "postal_code": "12742",
            "telephone_number": "845-794-1400",
            "fax_number": "845-794-8909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIATAK",
        "first_name": "JESSICA",
        "middle_name": "LEE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-18",
        "last_updated": "2011-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "PA",
            "license": "OC008366",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "010781-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "TEZYK",
            "middle_name": "LEE",
            "credential": "OTR/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Harris, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2011; 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.