NPIMap

Organization Active NPI

Jump Start Therapy Place

  • Physical Therapist
  • Staten Island, NY
National Provider Identifier
1316203946
Registry record updated Oct 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
05516 Issued in NY
Legal business name
JUMP START THERAPY PLACE
Practice address
4131 Richmond Ave
Staten Island, NY 10312-5633
Phone
(718) 351-0308
NPI assigned
Apr 9, 2012
Last updated
Oct 12, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2016

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

Authorized official

Name
Mrs. Yelena Nemtsova, PT, DPTNPI 1619111689
Title
President
Phone
(917) 622-2612

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 05516 NY Primary
Occupational Therapist 225X00000X 006852 NY

Addresses

Primary practice location

4131 Richmond Ave
Staten Island, NY 10312-5633

Mailing address

4131 Richmond Ave
Staten Island, NY 10312-5633
Phone (718) 351-0308

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1333929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476230400000",
    "number": "1316203946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4131 RICHMOND AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103125633",
            "telephone_number": "718-351-0308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4131 RICHMOND AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103125633",
            "telephone_number": "718-351-0308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUMP START THERAPY PLACE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-09",
        "last_updated": "2016-10-12",
        "status": "A",
        "authorized_official_last_name": "NEMTSOVA",
        "authorized_official_first_name": "YELENA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "917-622-2612",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "05516",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "006852",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2016; 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.