Individual provider Active NPI

Sara Hennessey, OT

  • Occupational Therapist
  • East Syracuse, NY
National Provider Identifier
1285283291
Registry record updated Sep 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
023983 Issued in NY
Practice address
5823 Widewaters Pkwy Ste 3
East Syracuse, NY 13057-3081
Phone
(315) 418-4013
Fax
(315) 478-0388
NPI assigned
Sep 11, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2019

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 023983 NY Primary

Addresses

Primary practice location

5823 Widewaters Pkwy Ste 3
East Syracuse, NY 13057-3081

Mailing address

5823 Widewaters Pkwy Ste 3
East Syracuse, NY 13057-3081
Phone (315) 418-4013

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191021002830 NY Practitioner - Occupational Therapist in Private Practice 4385976513 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

415 E 37TH St
Apt 21a
New York, NY 10016-3243
Phone (313) 525-1310

5719 Widewaters Pkwy
Syracuse, NY 13214-1985
Phone (315) 251-3100

8324 Oswego Rd
Liverpool, NY 13090-1086

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Syracuse Orthopedic Specialists, PLLC CurrentSince Sep 11, 2019 Accepting new patients
Syracuse Orthopedic Specialists, PLLC PastSince Sep 15, 2019 Accepting new patients

Locations

5823 Widewaters Pkwy
Ste 3
East Syracuse, NY 13057
Phone (315) 418-4000

5719 Widewaters Pkwy
Syracuse, NY 13214
Phone (315) 251-3110

Organizations & group practices 2

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": "1568160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568160000000",
    "number": "1285283291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5823 WIDEWATERS PKWY STE 3",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130573081",
            "telephone_number": "315-418-4013",
            "fax_number": "315-478-0388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5823 WIDEWATERS PKWY STE 3",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130573081",
            "telephone_number": "315-418-4013",
            "fax_number": "315-478-0388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENNESSEY",
        "first_name": "SARA",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-11",
        "last_updated": "2019-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "023983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.