Individual provider Active NPI

Jason Paul Van de Ven, OTRL

  • Occupational Therapist
  • New York, NY
National Provider Identifier
1629274568
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
009277 Issued in NY
Practice address
1 Gustave L Levy PL
Box 1674
New York, NY 10029-6500
Phone
(212) 241-9187
NPI assigned
Jun 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 009277 NY Primary

Addresses

Primary practice location

1 Gustave L Levy PL
Box 1674
New York, NY 10029-6500

Mailing address

2249 36TH St
2ND Floor
Astoria, NY 11105-2210
Phone (718) 726-5205

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

State licenses

LicenseStateTypeSpecialty
009277NYMDMental Health Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1182816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629274568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2249 36TH ST",
            "address_2": "2ND FLOOR",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111052210",
            "telephone_number": "718-726-5205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GUSTAVE L LEVY PL",
            "address_2": "BOX 1674",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296500",
            "telephone_number": "212-241-9187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN DE VEN",
        "first_name": "JASON",
        "middle_name": "PAUL",
        "name_prefix": "Mr.",
        "credential": "OTRL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "009277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.