Active NPI
Jerslin De Sousa, DC
- Chiropractor
- Brooklyn, NY
National Provider Identifier
1376053082
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- X012739-1
- Practice address
- 1650 Eastern Pkwy
Brooklyn, NY 11233-4804 - Phone
- (646) 588-8000
- NPI assigned
- Oct 8, 2017
- Last updated
- May 30, 2019
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | X012739-1 | NY | Primary |
| Independent Medical Examiner Chiropractor | 111NI0013X | X0121739-1 | NY |
Addresses
Primary practice location
1650 Eastern Pkwy
Brooklyn, NY 11233-4804
Mailing address
1650 Eastern Pkwy
Brooklyn, NY 11233-4804
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| X012739-1 | NY | MD | Chiropractor |
| X0121739-1 | NY | MD | Independent Medical Examiner Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1507420800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1559174400000",
"number": "1376053082",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1650 EASTERN PKWY",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112334804"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1650 EASTERN PKWY",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112334804",
"telephone_number": "646-588-8000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE SOUSA",
"first_name": "JERSLIN",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-10-08",
"last_updated": "2019-05-30",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NY",
"license": "X012739-1",
"primary": true
},
{
"code": "111NI0013X",
"taxonomy_group": "",
"desc": "Chiropractor, Independent Medical Examiner",
"state": "NY",
"license": "X0121739-1",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.