Individual provider Active NPI

Jetaime Montes

  • Massage Therapist
  • Islip Terrace, NY
National Provider Identifier
1700522612
Registry record updated May 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
027967-01 Issued in NY
Practice address
126 Carleton Ave
Islip Terrace, NY 11752-2639
Phone
(516) 330-9817
NPI assigned
May 12, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 027967-01 NY Primary

Addresses

Primary practice location

126 Carleton Ave
Islip Terrace, NY 11752-2639

Mailing address

9 Winnifred St
Bay Shore, NY 11706-6525

Other practice location 1

680 Ny-112
East Patchogue, NY 11772
Phone (516) 330-9817

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
027967-01NYMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Margaret M. Magee, R.N., L.M.T., PLLC Massage Therapist CurrentSince Jul 10, 2022 Accepting new patients

Locations

126 Carleton Ave
Islip Terrace, NY 11752
Phone (516) 330-9817

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": "1652313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652313600000",
    "number": "1700522612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 WINNIFRED ST",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117066525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 CARLETON AVE",
            "city": "ISLIP TERRACE",
            "state": "NY",
            "postal_code": "117522639",
            "telephone_number": "516-330-9817"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "680 NY-112",
            "address_purpose": "LOCATION",
            "city": "East Patchogue",
            "state": "NY",
            "postal_code": "11772",
            "country_code": "US",
            "telephone_number": "516-330-9817",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MONTES",
        "first_name": "JETAIME",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-12",
        "last_updated": "2022-05-12",
        "certification_date": "2022-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NY",
            "license": "027967-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Islip Terrace, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2022; 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.