Organization Active NPI

Aspire365 New York LLC

  • Addiction Medicine (Preventive Medicine) Physician
  • New York, NY
National Provider Identifier
1154039196
Registry record updated Oct 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Preventive Medicine) PhysicianTaxonomy code 2083A0300X
Legal business name
ASPIRE365 NEW YORK LLC
Practice address
26 Broadway Ste 934-C54
New York, NY 10004-1703
Phone
(385) 352-9696
Fax
(385) 287-1035
NPI assigned
Nov 8, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2024

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

Authorized official

Name
Zach Jenson
Title
Ceo
Phone
(385) 352-9746

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X
Addiction (Substance Use Disorder) PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TA0400X
Addiction (Substance Use Disorder) Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WA0400X
Addiction Medicine (Preventive Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2083A0300X Primary
Addiction Medicine (Psychiatry & Neurology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084A0401X

Addresses

Primary practice location

26 Broadway Ste 934-C54
New York, NY 10004-1703

Mailing address

9350 S 150 E Ste 320
Sandy, UT 84070-2707
Phone (385) 352-9696

National Provider Directory

National Provider Directory

Locations

26 Broadway
Ste 934
New York, NY 10004
Phone (516) 303-2790

NPI Registry JSON

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

{
    "created_epoch": "1667865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728864000000",
    "number": "1154039196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9350 S 150 E STE 320",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840702707",
            "telephone_number": "385-352-9696",
            "fax_number": "385-287-1035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 BROADWAY STE 934-C54",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100041703",
            "telephone_number": "385-352-9696",
            "fax_number": "385-287-1035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASPIRE365 NEW YORK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-08",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A",
        "authorized_official_last_name": "JENSON",
        "authorized_official_first_name": "ZACH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "385-352-9746"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163WA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2083A0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084A0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2024; 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.