Individual provider Active NPI

Carmen Luisa De Jesus, L.AC., LMT

  • Acupuncturist
  • Brooklyn, NY
National Provider Identifier
1134553274
Registry record updated Aug 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
25005059 Issued in NY
Practice address
2322 E 18TH St
Brooklyn, NY 11229-4417
Phone
(585) 746-7677
NPI assigned
Aug 26, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 25005059 NY Primary
Massage Therapist 225700000X 018323 NY

Addresses

Primary practice location

2322 E 18TH St
Brooklyn, NY 11229-4417

Mailing address

22 E 17TH St
Suite 511
New York, NY 10003-1901

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

State licenses

LicenseStateTypeSpecialty
25005059NYMDAcupuncturist
018323NYMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1377475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377475200000",
    "number": "1134553274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 E 17TH ST",
            "address_2": "SUITE 511",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100031901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2322 E 18TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112294417",
            "telephone_number": "585-746-7677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE JESUS",
        "first_name": "CARMEN",
        "middle_name": "LUISA",
        "credential": "L.AC., LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-26",
        "last_updated": "2013-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NY",
            "license": "25005059",
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NY",
            "license": "018323",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2013; 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.