Individual provider Active NPI

Jessa Mariah Mitra Legaspi, PT

  • Physical Therapist
  • Hauppauge, NY
National Provider Identifier
1275408486
Registry record updated Oct 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
045859-01 Issued in NY
Practice address
731 Wheeler Road
Hauppauge, NY 11788
Phone
(631) 374-0929
NPI assigned
Oct 7, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 045859-01 NY Primary

Addresses

Primary practice location

731 Wheeler Road
Hauppauge, NY 11788

Mailing address

731 Wheeler Road
Hauppauge, NY 11788
Phone (631) 374-0929

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
045859-01NYMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1759795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759795200000",
    "number": "1275408486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "731 WHEELER ROAD",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "11788",
            "telephone_number": "631-374-0929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "731 WHEELER ROAD",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "11788",
            "telephone_number": "631-374-0929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEGASPI",
        "first_name": "JESSA MARIAH",
        "middle_name": "MITRA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-07",
        "last_updated": "2025-10-07",
        "certification_date": "2025-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "045859-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hauppauge, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2025; 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.