Individual provider Active NPI

Jeanine A Barrera, O.T

  • Occupational Therapy Assistant
  • Bethpage, NY
National Provider Identifier
1174740906
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
012238 Issued in NY
Practice address
807 S Oyster Bay Rd
Bethpage, NY 11714-1030
Phone
(516) 622-8888
Fax
(516) 342-2480
NPI assigned
Apr 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 012238 NY Primary

Addresses

Primary practice location

807 S Oyster Bay Rd
Bethpage, NY 11714-1030

Mailing address

235 Candlewood Path
Dix Hills, NY 11746-8003

Other identifiers 1

IdentifierTypeStateIssuer
012238OtherNYLICENSE

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

NPI Registry JSON

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174740906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 CANDLEWOOD PATH",
            "city": "DIX HILLS",
            "state": "NY",
            "postal_code": "117468003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "807 S OYSTER BAY RD",
            "city": "BETHPAGE",
            "state": "NY",
            "postal_code": "117141030",
            "telephone_number": "516-622-8888",
            "fax_number": "516-342-2480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARRERA",
        "first_name": "JEANINE",
        "middle_name": "A",
        "credential": "O.T",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NY",
            "license": "012238",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "012238",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethpage, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.