Organization Active NPI

Jill E Smith OT PLLC

  • Occupational Therapist
  • Baldwin, NY
National Provider Identifier
1184152936
Registry record updated May 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Legal business name
JILL E SMITH OT PLLC
Practice address
865 Merrick Rd Ste 201
Baldwin, NY 11510-3338
Phone
(516) 238-7818
NPI assigned
May 24, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 24, 2017

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

Authorized official

Name
Jill E Smith, OTR/NPI 1972822633
Title
Occupational Therapist
Phone
(516) 238-7818

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225X00000X Primary

Addresses

Primary practice location

865 Merrick Rd Ste 201
Baldwin, NY 11510-3338

Mailing address

76 Intervale
Rockville Centre, NY 11570-4516
Phone (516) 238-7818

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171228001353 NY Part B Supplier - Physical/Occupational Therapy Group in Private Practice 3375801178 Receives reassigned benefits from 2 practitioners
Practice locations: Rockville Centre, NY

National Provider Directory

National Provider Directory

Locations

865 Merrick Rd
Ste 201
Baldwin, NY 11510
Phone (516) 238-7818

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1495584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1495584000000",
    "number": "1184152936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76 INTERVALE",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115704516",
            "telephone_number": "516-238-7818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "865 MERRICK RD STE 201",
            "city": "BALDWIN",
            "state": "NY",
            "postal_code": "115103338",
            "telephone_number": "516-238-7818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JILL E SMITH OT PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-24",
        "last_updated": "2017-05-24",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "JILL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPIST",
        "authorized_official_telephone_number": "516-238-7818",
        "authorized_official_credential": "OTR/"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baldwin, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.