Individual provider Active NPI

Sophia Parise

  • Massage Therapist
  • Port Jefferson Station, NY
National Provider Identifier
1396406294
Registry record updated Jan 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
032054 Issued in NY
Practice address
59 Nesconset Hwy
Port Jefferson Station, NY 11776-2628
Phone
(631) 740-4306
NPI assigned
Jan 4, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 032054 NY Primary

Addresses

Primary practice location

59 Nesconset Hwy
Port Jefferson Station, NY 11776-2628

Mailing address

35 Ontario St
Port Jefferson Station, NY 11776-4345
Phone (631) 740-4306

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

LicenseStateTypeSpecialty
032054NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1641254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641254400000",
    "number": "1396406294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 ONTARIO ST",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117764345",
            "telephone_number": "631-740-4306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59 NESCONSET HWY",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117762628",
            "telephone_number": "631-740-4306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARISE",
        "first_name": "SOPHIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-04",
        "last_updated": "2022-01-04",
        "certification_date": "2022-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NY",
            "license": "032054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Jefferson Station, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2022; 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.