Jennifer Noronha, PHD. OTR/L
Individual provider Active NPI Occupational Therapist · Williston Park, NY
NPI 1588949697 · NPPES record last updated Oct 20, 2011
Key facts
- NPI
- 1588949697
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- 006165-1 (NY)
- Practice address
- 188 Colonial Ave
Williston Park, NY 11596-1046 - Phone
- (516) 551-4176
- NPI assigned
- Oct 20, 2011
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Occupational Therapist in Private Practice
- Education
- Other, 1986
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Epic Medical Services PC
Practice addresses (Care Compare)
1500 Hempstead Tpke
East Meadow, NY 11554-1551
Phone (516) 739-7733
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20051012000484 | NY | Practitioner - Occupational Therapist in Private Practice | 9537184163 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 006165-1 | NY | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Epic Medical Services PC | Current |
Accepting new patients | |
| Welllife Network Inc. | Past | Accepting new patients | |
| Welllife Network Inc | Past | Accepting new patients |
Locations
1500 Hempstead Tpke
East Meadow, NY 11554
Phone 51673977331420
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 006165-1 | NY | Yes |
Addresses
Primary practice location
188 Colonial Ave
Williston Park, NY 11596-1046
Mailing address
188 Colonial Ave
Williston Park, NY 11596-1046
Phone (516) 551-4176
Other providers in Williston Park, NY
- Bridget Jean Devaney Nerses
- New York Legal Nurse Consultants Inc
- Next Step Podiatry PLLC
- Stephanie Nigro
- Nimble Solution Inc
- Norris Chiropractic P.C.
- Joyce Marie Norris
- North Shore Dermatology Associates,P.C.
- North Shore Medical Labs Inc.
- Michael Neville Norton
All providers in Williston Park, NY · Occupational Therapist in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 20, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.