Individual provider Active NPI

Jennifer Marie Defeo, OTR/L

  • Occupational Therapist
  • Farmingdale, NY
National Provider Identifier
1528087673
Registry record updated Mar 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
013321 Issued in NY
Practice address
123 W Walnut St
Farmingdale, NY 11735-3142
Phone
(516) 641-3058
NPI assigned
Jul 19, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2008

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 013321 NY Primary

Addresses

Primary practice location

123 W Walnut St
Farmingdale, NY 11735-3142

Mailing address

123 W Walnut St
Farmingdale, NY 11735-3142
Phone (516) 641-3058

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070503000046 NY Practitioner - Occupational Therapist in Private Practice 2365548666 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1325 Franklin Ave
Garden City, NY 11530-1666
Phone (516) 280-8811

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
013321NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Liht Occupational Therapy PC Occupational Therapist CurrentSince Mar 1, 2007 Accepting new patients
Liht Occupational Therapy PC Current Accepting new patients
Elite Performance Physical Therapy PC CurrentSince Nov 9, 2009 Accepting new patients

Locations

1325 Franklin Ave
Ste LL105
Garden City, NY 11530
Phone (516) 280-8811

300 Hempstead Tpke
Unit 3
West Hempstead, NY 11552

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": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205366400000",
    "number": "1528087673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 W WALNUT ST",
            "city": "FARMINGDALE",
            "state": "NY",
            "postal_code": "117353142",
            "telephone_number": "516-641-3058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 W WALNUT ST",
            "city": "FARMINGDALE",
            "state": "NY",
            "postal_code": "117353142",
            "telephone_number": "516-641-3058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEFEO",
        "first_name": "JENNIFER",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2008-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "013321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmingdale, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2008; 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.