Individual provider Active NPI

Jasmine A Cusimano, OTR/L

  • Occupational Therapist
  • Lakewood, NY
National Provider Identifier
1306133301
Registry record updated Jun 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
016815-1 Issued in NY
Practice address
140 Southwestern Dr
Lakewood, NY 14750-2117
Phone
(716) 338-0668
Fax
(866) 694-4979
NPI assigned
Jun 29, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2011

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 016815-1 NY Primary

Addresses

Primary practice location

140 Southwestern Dr
Lakewood, NY 14750-2117

Mailing address

140 Southwestern Dr
Lakewood, NY 14750-2117
Phone (716) 338-0668

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
016815-1NYMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1309305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309305600000",
    "number": "1306133301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 SOUTHWESTERN DR",
            "city": "LAKEWOOD",
            "state": "NY",
            "postal_code": "147502117",
            "telephone_number": "716-338-0668",
            "fax_number": "866-694-4979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 SOUTHWESTERN DR",
            "city": "LAKEWOOD",
            "state": "NY",
            "postal_code": "147502117",
            "telephone_number": "716-338-0668",
            "fax_number": "866-694-4979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUSIMANO",
        "first_name": "JASMINE",
        "middle_name": "A",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-29",
        "last_updated": "2011-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "016815-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2011; 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.