Individual provider Active NPI

Kristjana Hysaj, OTR/L

  • Occupational Therapist
  • Astoria, NY
National Provider Identifier
1578187373
Registry record updated Jun 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
024743 Issued in NY
Practice address
1445 31St Ave Apt 2D
Astoria, NY 11106-4536
Phone
(347) 712-2562
NPI assigned
Jun 8, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2020

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 024743 NY Primary

Addresses

Primary practice location

1445 31St Ave Apt 2D
Astoria, NY 11106-4536

Mailing address

1445 31St Ave Apt 2D
Astoria, NY 11106-4536
Phone (347) 712-2562

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220608001144 VA Practitioner - Occupational Therapist in Private Practice 5597143230 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
024743NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
JP Therapy, LLC CurrentSince May 23, 2022 Accepting new patients

Locations

5604 Virginia Beach Blvd
Ste 101
Virginia Beach, VA 23462

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": "1591574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591574400000",
    "number": "1578187373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1445 31ST AVE APT 2D",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111064536",
            "telephone_number": "347-712-2562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1445 31ST AVE APT 2D",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111064536",
            "telephone_number": "347-712-2562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HYSAJ",
        "first_name": "KRISTJANA",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-08",
        "last_updated": "2020-06-08",
        "certification_date": "2020-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "024743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Astoria, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2020; 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.

Verify at the official NPI Registry.