Individual provider Active NPI

Jonathan Tianchon, OTR

  • Occupational Therapist
  • Huntington Station, NY
National Provider Identifier
1669879383
Registry record updated Feb 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
019250-1 Issued in NY
Practice address
2375 New York Ave.
Huntington Station, NY 11756
Phone
(631) 421-9191
Fax
(631) 421-1979
NPI assigned
Nov 24, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2017

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 019250-1 NY Primary

Addresses

Primary practice location

2375 New York Ave.
Huntington Station, NY 11756

Mailing address

2375 New York Ave
Suite B
Huntington Station, NY 11746-4212
Phone (516) 421-9191

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180604002636 NY Practitioner - Occupational Therapist in Private Practice 3375808850 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Professional Occupational and Physical Therapy, PLLCGroup PAC ID 3779873401, 497 clinicians

Practice addresses (Care Compare)

121 Broadhollow Rd
Melville, NY 11747-4906
Phone (631) 425-1020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019250-1NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Occupational & Physical Therapy, PLLC Occupational Therapist CurrentSince May 25, 2018 Accepting new patients
Professional Occupational & Physical Therapy, PLLC Occupational Therapist CurrentSince May 25, 2018 Accepting new patients
Professional Occupational & Physical Therapy, PLLC Occupational Therapist Current Accepting new patients

Locations

123 Grove Ave
Cedarhurst, NY 11516
Phone (516) 374-4248

9131 Queens Blvd
Ste 310
Elmhurst, NY 11373
Phone (718) 424-7856

121 Broadhollow Rd
Melville, NY 11747
Phone (631) 354-5600

576 Broadhollow Rd
Melville, NY 11747

2142 Utopia Pkwy
Whitestone, NY 11357
Phone (718) 767-0610

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": "1416787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487548800000",
    "number": "1669879383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2375 NEW YORK AVE",
            "address_2": "SUITE B",
            "city": "HUNTINGTON STATION",
            "state": "NY",
            "postal_code": "117464212",
            "telephone_number": "516-421-9191",
            "fax_number": "516-421-1979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2375 NEW YORK AVE.",
            "city": "HUNTINGTON STATION",
            "state": "NY",
            "postal_code": "11756",
            "telephone_number": "631-421-9191",
            "fax_number": "631-421-1979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIANCHON",
        "first_name": "JONATHAN",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-11-24",
        "last_updated": "2017-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "019250-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington Station, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2017; 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.