Individual provider Active NPI

Joseph John McGovern, OT

  • Occupational Therapist
  • Holbrook, NY
National Provider Identifier
1386772119
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
008306-1 Issued in NY
Practice address
7 Lou CT
Holbrook, NY 11741-5808
Phone
(631) 567-5763
Fax
(631) 567-5763
NPI assigned
Mar 1, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 008306-1 NY Primary

Addresses

Primary practice location

7 Lou CT
Holbrook, NY 11741-5808

Mailing address

7 Lou CT
Holbrook, NY 11741-5808
Phone (631) 567-5763

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080104000163 NY Practitioner - Occupational Therapist in Private Practice 2567542442 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
008306-1NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Medcare Therapy Services:Physical, Occupational & Massage Therapy,PLLC Occupational Therapist CurrentSince Dec 27, 2010 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386772119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 LOU CT",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117415808",
            "telephone_number": "631-567-5763",
            "fax_number": "631-567-5763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 LOU CT",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117415808",
            "telephone_number": "631-567-5763",
            "fax_number": "631-567-5763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGOVERN",
        "first_name": "JOSEPH",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "OT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "008306-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holbrook, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.