Active NPI
Jesse Andrew Defilippo, OT
- Occupational Therapist
- New Hyde Park, NY
National Provider Identifier
1124511761
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 021861
- Practice address
- 5 Dakota Dr Ste 200
New Hyde Park, NY 11042-1109 - Phone
- (631) 752-0400
- NPI assigned
- Jun 8, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 021861 | NY | Primary |
Addresses
Primary practice location
5 Dakota Dr Ste 200
New Hyde Park, NY 11042-1109
Mailing address
18 Monarch Street
Port Jefferson Station, NY 11776
Phone (631) 702-0105
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
| License | State | Type | Specialty |
|---|---|---|---|
| 021861 | NY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528416000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1528416000000",
"number": "1124511761",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18 MONARCH STREET",
"city": "PORT JEFFERSON STATION",
"state": "NY",
"postal_code": "11776",
"telephone_number": "631-702-0105"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5 DAKOTA DR STE 200",
"city": "NEW HYDE PARK",
"state": "NY",
"postal_code": "110421109",
"telephone_number": "631-752-0400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEFILIPPO",
"first_name": "JESSE",
"middle_name": "ANDREW",
"name_prefix": "Mr.",
"credential": "OT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-06-08",
"last_updated": "2018-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "021861",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Hyde Park, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.