Individual provider Active NPI

Jessica Shulman, PT,DPT

  • Physical Therapist
  • Manhasset, NY
National Provider Identifier
1316772213
Registry record updated Oct 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
052571 Issued in NY
Practice address
1554 Northern Blvd FL 3
Manhasset, NY 11030-3054
Phone
(516) 719-3700
NPI assigned
Sep 3, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 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 052571 NY Primary

Addresses

Primary practice location

1554 Northern Blvd FL 3
Manhasset, NY 11030-3054

Mailing address

972 Brush Hollow Rd FL 4
Westbury, NY 11590-1740

Other names 1

  • Jessica Wynne Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250214002103 NY Practitioner - Physical Therapist in Private Practice 3779013073 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist CurrentSince Feb 1, 2025 Accepting new patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist CurrentSince Feb 1, 2025 Accepting new patients
Sports Physical Therapy Occupational Therapy and Rehabilitation Servic Physical Therapist CurrentSince Feb 1, 2025 Accepting new patients
Sports Physical Therapy Occupational Therapy and Rehabilitation Servic CurrentSince Feb 1, 2025 Accepting new patients
Professional Occupational & Physical Therapy, PLLC Physical Therapist Current Accepting new patients

Locations

123 Grove Ave
Cedarhurst, NY 11516
Phone (516) 374-4248

645 Stewart Ave
Garden City, NY 11530
Phone (516) 794-3278

145 Community Dr
Great Neck, NY 11021
Phone (516) 465-8260

576 Broadhollow Rd
Melville, NY 11747

972 Brush Hollow Rd
Fl 4
Westbury, NY 11590
Phone (516) 321-7526

2142 Utopia Pkwy
Whitestone, NY 11357
Phone (718) 767-0610

Organizations & group practices 5

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": "1725321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759881600000",
    "number": "1316772213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "972 BRUSH HOLLOW RD FL 4",
            "city": "WESTBURY",
            "state": "NY",
            "postal_code": "115901740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1554 NORTHERN BLVD FL 3",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "110303054",
            "telephone_number": "516-719-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHULMAN",
        "first_name": "JESSICA",
        "credential": "PT,DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-03",
        "last_updated": "2025-10-08",
        "certification_date": "2025-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "052571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "WYNNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Manhasset, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.