Active NPI
Jamie Desjardins, PH.D., CCC-A
- Audiologist
- Syracuse, NY
National Provider Identifier
1366790974
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 001930-1
- Practice address
- 805 S Crouse Ave
Syracuse, NY 13210-1714 - Phone
- (315) 443-4485
- Fax
- (315) 443-1113
- NPI assigned
- Aug 29, 2012
- Last updated
- Aug 29, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | 001930-1 | NY | Primary |
Addresses
Primary practice location
805 S Crouse Ave
Syracuse, NY 13210-1714
Mailing address
805 S Crouse Ave
Syracuse, NY 13210-1714
Phone (315) 443-4485
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001930 | NY | MD | Behavioral Analyst |
| 001930-1 | NY | MD | Audiologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Syracuse University | Past | Accepting new patients | |
| Syracuse University | Audiologist | Past | Accepting new patients |
| Syracuse University | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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- Student Health Clinic/Center
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- NPI 1447338819
-
- Audiologist
- Syracuse, NY
- NPI 1558339473
-
- Speech-Language Pathologist
- Syracuse, NY
- NPI 1609928217
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1346198400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1346198400000",
"number": "1366790974",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "805 S CROUSE AVE",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132101714",
"telephone_number": "315-443-4485",
"fax_number": "315-443-1113"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "805 S CROUSE AVE",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132101714",
"telephone_number": "315-443-4485",
"fax_number": "315-443-1113"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DESJARDINS",
"first_name": "JAMIE",
"name_prefix": "Dr.",
"credential": "PH.D., CCC-A",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-08-29",
"last_updated": "2012-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "NY",
"license": "001930-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Syracuse, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.