Individual provider Active NPI

Jennifer Corry

  • Occupational Therapist
  • Dix Hills, NY
National Provider Identifier
1346369915
Registry record updated Sep 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
9178 Issued in MA
Practice address
1 Waydale Dr
Dix Hills, NY 11746-5221
Phone
(631) 680-3356
NPI assigned
Mar 28, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2013

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 9178 MA Primary

Addresses

Primary practice location

1 Waydale Dr
Dix Hills, NY 11746-5221

Mailing address

1 Waydale Dr
Dix Hills, NY 11746-5221

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140715001625 NY Practitioner - Occupational Therapist in Private Practice 6204051832 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10 Cheshire PL
East Northport, NY 11731-2503
Phone (631) 651-9333

505 Grand Blvd
Deer Park, NY 11729-5300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
015785NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Medcare Therapy Services:Physical, Occupational & Massage Therapy,PLLC Occupational Therapist CurrentSince Oct 7, 2019 Accepting new patients
Sky Physical Therapy, PLLC CurrentSince Aug 1, 2014 Accepting new patients
Deer Park PT & Pta Physical Therapy & Rehabilitation, PLLC CurrentSince Nov 17, 2014 Accepting new patients
We Care Physical Therapy, P.C. CurrentSince May 1, 2014 Accepting new patients

Locations

505 Grand Blvd
Ste 4
Deer Park, NY 11729
Phone (631) 643-7656

510 Ocean Ave
East Rockaway, NY 11518
Phone (516) 399-2225

Organizations & group practices 4

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": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379548800000",
    "number": "1346369915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 WAYDALE DR",
            "city": "DIX HILLS",
            "state": "NY",
            "postal_code": "117465221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WAYDALE DR",
            "city": "DIX HILLS",
            "state": "NY",
            "postal_code": "117465221",
            "telephone_number": "631-680-3356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORRY",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-28",
        "last_updated": "2013-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MA",
            "license": "9178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dix Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2013; 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.