Active NPI
Jaclyn Kassi Shapiro, MS, OTR/L
- Occupational Therapist
- Deer Park, NY
National Provider Identifier
1588901722
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 017641
- Practice address
- 201 Baldwin Path
Deer Park, NY 11729-1407 - Phone
- (631) 804-9443
- NPI assigned
- Jan 8, 2013
- Sex
- Female
- Sole proprietor
- No
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 | 017641 | NY | Primary |
Addresses
Primary practice location
201 Baldwin Path
Deer Park, NY 11729-1407
Mailing address
201 Baldwin Path
Deer Park, NY 11729-1407
Phone (631) 804-9443
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 017641 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1357603200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1357603200000",
"number": "1588901722",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "201 BALDWIN PATH",
"city": "DEER PARK",
"state": "NY",
"postal_code": "117291407",
"telephone_number": "631-804-9443"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 BALDWIN PATH",
"city": "DEER PARK",
"state": "NY",
"postal_code": "117291407",
"telephone_number": "631-804-9443"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAPIRO",
"first_name": "JACLYN",
"middle_name": "KASSI",
"credential": "MS, OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-01-08",
"last_updated": "2013-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "017641",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Deer Park, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.