Active NPI
Jason Kean, COTA
- Occupational Therapy Assistant
- Monticello, NY
National Provider Identifier
1437364379
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 007094
- Practice address
- 606 Old Route 17
Monticello, NY 12701-7013 - Phone
- (845) 665-6795
- NPI assigned
- May 14, 2007
- Last updated
- Aug 11, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | OP006416 | PA | |
| Occupational Therapy Assistant | 224Z00000X | 007094 | NY | Primary |
Addresses
Primary practice location
606 Old Route 17
Monticello, NY 12701-7013
Mailing address
138 Champlin Ave
Liberty, NY 12754-1617
Phone (845) 665-6795
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
| License | State | Type | Specialty |
|---|---|---|---|
| 007094 | NY | MD | Occupational Therapy Assistant |
| OP006416 | PA | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179100800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1281484800000",
"number": "1437364379",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "138 CHAMPLIN AVE",
"city": "LIBERTY",
"state": "NY",
"postal_code": "127541617",
"telephone_number": "845-665-6795"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "606 OLD ROUTE 17",
"city": "MONTICELLO",
"state": "NY",
"postal_code": "127017013",
"telephone_number": "845-665-6795"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEAN",
"first_name": "JASON",
"credential": "COTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-14",
"last_updated": "2010-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "PA",
"license": "OP006416",
"primary": false
},
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "NY",
"license": "007094",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Monticello, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.