Individual provider Active NPI

Jonathan Matthew Pimentel, OTR/L

  • Occupational Therapist
  • Bronx, NY
National Provider Identifier
1194238691
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
022000 Issued in NY
Practice address
1977 Chatterton Ave
Bronx, NY 10472-6044
Phone
(347) 285-5931
NPI assigned
Nov 7, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 022000 NY Primary

Addresses

Primary practice location

1977 Chatterton Ave
Bronx, NY 10472-6044

Mailing address

1977 Chatterton Ave
Bronx, NY 10472-6044
Phone (347) 285-5931

Other identifiers 1

IdentifierTypeStateIssuer
WH45741DMedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200330000833 NY Practitioner - Occupational Therapist in Private Practice 6709215676 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Complete SLP, OT, PT & Psychology Services, PLLC CurrentSince Sep 1, 2020 Accepting new patients
Caring SLP, Psychology, OT & Nutrition Services, PLLC CurrentSince Mar 1, 2020 Accepting new patients
Essential OT, PT, SLP & Psychology Services, PLLC CurrentSince Sep 1, 2020 Accepting new patients
Essential Therapy Services of NJ Occupational Therapist PastSince Oct 1, 2021 Accepting new patients

Locations

17 N Plank Rd
Ste 10
Newburgh, NY 12550
Phone (845) 800-9305

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1510012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1194238691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1977 CHATTERTON AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104726044",
            "telephone_number": "347-285-5931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1977 CHATTERTON AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104726044",
            "telephone_number": "347-285-5931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIMENTEL",
        "first_name": "JONATHAN",
        "middle_name": "MATTHEW",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-11-07",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "022000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "WH45741D",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.