Jacqueline A Jim, OT/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

008281-1 Issued in NY

Practice address

3205 Green MDW
Baldwinsville, NY 13027

Phone

(315) 857-4481

NPI assigned

Jul 2, 2009

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

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

PRN Physical, Occupational and Speech Therapy Network, PLLCGroup PAC ID 5092730788, 84 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• PRN Physical, Occupational and Speech Therapy Network, PLLC

  • Physical Therapist
  • East Greenbush, NY
  • NPI 1336185263
  Medicare reassignment Care Compare group NPD
• PRN Physical, Occupational and Speech Therapy Network, PLLC

  • Durable Medical Equipment & Medical Supplies
  • Troy, NY
  • NPI 1568059665
  NPD

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

{
    "created_epoch": "1246492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533513600000",
    "number": "1417186123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3205 GREEN MDW",
            "city": "BALDWINSVILLE",
            "state": "NY",
            "postal_code": "130278929",
            "telephone_number": "315-857-4481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3205 GREEN MDW",
            "city": "BALDWINSVILLE",
            "state": "NY",
            "postal_code": "13027",
            "telephone_number": "315-857-4481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIM",
        "first_name": "JACQUELINE",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "OT/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-02",
        "last_updated": "2018-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "008281-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grace Jacobs
• Daniel Janecek
• Joanna Jann, MSOT/L
• Jemma Home Care LLC
• Jessica Butler LCSW PLLC
• Loretta Johnson, BSN, RN
• Amy Johnstone
• Lori Ann Johnstone, M.S. CCC-SLP
• Donna S. Jones, RN
• Matthew Jones, COTA

• Occupational Therapist in Baldwinsville, NY
• Providers in Baldwinsville, NY by specialty
• Occupational Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2018; 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.