Individual provider Active NPI

Jessica B Guzman, OTR/L

  • Occupational Therapist
  • Kings Park, NY
National Provider Identifier
1396078838
Registry record updated Jan 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
009968 Issued in NY
Practice address
4 Raleigh LN
Kings Park, NY 11754-4418
Phone
(631) 269-4424
NPI assigned
Sep 16, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 13, 2014

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 009968 NY Primary

Addresses

Primary practice location

4 Raleigh LN
Kings Park, NY 11754-4418

Mailing address

4 Raleigh LN
Kings Park, NY 11754-4418
Phone (631) 269-4424

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140110000155 NY Practitioner - Occupational Therapist in Private Practice 9931337342 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
State University of New York at Stony Brook, School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

510 Ocean Ave
East Rockaway, NY 11518-1208
Phone (631) 909-4678

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sky Physical Therapy, PLLC CurrentSince Aug 1, 2014 Accepting new patients
We Care Physical Therapy, P.C. CurrentSince Oct 15, 2013 Accepting new patients
Medcare Therapy Services:Physical, Occupational & Massage Therapy,PLLC Occupational Therapist CurrentSince Dec 13, 2016 Accepting new patients

Locations

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

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1253059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389571200000",
    "number": "1396078838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 RALEIGH LN",
            "city": "KINGS PARK",
            "state": "NY",
            "postal_code": "117544418",
            "telephone_number": "631-269-4424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 RALEIGH LN",
            "city": "KINGS PARK",
            "state": "NY",
            "postal_code": "117544418",
            "telephone_number": "631-269-4424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUZMAN",
        "first_name": "JESSICA",
        "middle_name": "B",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-16",
        "last_updated": "2014-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "009968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kings Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2014; 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.