Active NPI
Jennifer L Donnelly
- Occupational Therapist
- Syracuse, NY
National Provider Identifier
1467677799
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 013234
- Practice address
- 813 Fay Rd
Syracuse, NY 13219-3009 - Phone
- (315) 488-2831
- NPI assigned
- Apr 13, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 013234 | NY | Primary |
Addresses
Primary practice location
813 Fay Rd
Syracuse, NY 13219-3009
Mailing address
720 Hamilton St
Syracuse, NY 13204-1818
Phone (315) 488-2831
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250805003939 | NY | Practitioner - Occupational Therapist in Private Practice | 9830607274 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 013234 | NY | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Neuro Fit PT and SLP PLLC | Occupational Therapist | Past | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176422400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1467677799",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "720 HAMILTON ST",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132041818",
"telephone_number": "315-488-2831"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "813 FAY RD",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132193009",
"telephone_number": "315-488-2831"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DONNELLY",
"first_name": "JENNIFER",
"middle_name": "L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "013234",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Syracuse, 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.