Olivia Lucia Janssen, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

191 Patchogue Yaphank Rd
East Patchogue, NY 11772-4899

Phone

(631) 775-0971

Fax

(631) 475-0975

NPI assigned

Nov 6, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

State University of New York at Stony Brook, School of Medicine, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Professional Care Physical Therapy and Rehabilitation P.CGroup PAC ID 7517023351, 23 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Professional Care Physical Therapy and Rehabilitation P.C

  • Physical Therapist
  • East Patchogue, NY
  • NPI 1659518157
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1730851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730851200000",
    "number": "1316760416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "191 PATCHOGUE YAPHANK RD",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117724899",
            "telephone_number": "631-775-0971",
            "fax_number": "631-475-0975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 PATCHOGUE YAPHANK RD",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117724899",
            "telephone_number": "631-775-0971",
            "fax_number": "631-475-0975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANSSEN",
        "first_name": "OLIVIA",
        "middle_name": "LUCIA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-06",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sanjeev Jain, MD
• Jong Chu Jean, MD
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• Seheui Jo, D.D.S.
• Olivia Joiles, LMSW
• Justeena Joseph, MD

• Physical Therapist in East Patchogue, NY
• Providers in East Patchogue, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2024; 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.