Gina Otis, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

010973 Issued in NY

Practice address

196 N Belle Mead Rd Ste 3
East Setauket, NY 11733-3477

Phone

(631) 445-9937

NPI assigned

Jan 13, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1578873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579132800000",
    "number": "1376183731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 IMPALA DR",
            "city": "CENTEREACH",
            "state": "NY",
            "postal_code": "117201505",
            "telephone_number": "631-445-9937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "196 N BELLE MEAD RD STE 3",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117333477",
            "telephone_number": "631-445-9937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTIS",
        "first_name": "GINA",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-13",
        "last_updated": "2020-01-16",
        "certification_date": "2020-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "NY",
            "license": "010973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "refusetoquit@optonline.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "196 N Belle Mead Rd Ste 3",
            "city": "East Setauket",
            "state": "NY",
            "country_code": "US",
            "postal_code": "117333477",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Orthopedic Assoc of Long Island Physicians & Medical Group PLLC
• Orthopedic Assoc of Long Island Physicians & Medical Group PLLC
• Orthopedic Assoc of Long Island Physicians and Medical Group PLLC
• Orthopedic Associates of Long Island, LLP
• Jennifer Nicole Osipoff, MD
• Michael Ouzounian
• Kerri Elizabeth Owens, OTRL
• Michael F Paccione, M.D.
• Lori Ann Pagano, LCSW
• Patricia J Pahk, M.D.

• Massage Therapist in East Setauket, NY
• Providers in East Setauket, NY by specialty
• Massage Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.