NPIMap

Individual provider Active NPI

Jill M Tresidder, OT

  • Occupational Therapist
  • Bronx, NY
National Provider Identifier
1770508996
Registry record updated Mar 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
011983 Issued in NY
Practice address
907 E Tremont Ave
Bronx, NY 10460-4301
Phone
(914) 328-8077
Fax
(914) 328-6083
NPI assigned
Jul 12, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 16, 2018

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 011983 NY Primary

Addresses

Primary practice location

907 E Tremont Ave
Bronx, NY 10460-4301

Mailing address

907 E Tremont Ave
Bronx, NY 10460-4301
Phone (914) 328-8077

Other names 1

  • Jill Stillman Other name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
011983NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Doctors United, Inc PastSince Dec 8, 2003 Accepting new patients
R.G. Medical, PC Past Accepting new patients

Organizations & group practices 2

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521158400000",
    "number": "1770508996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "907 E TREMONT AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104604301",
            "telephone_number": "914-328-8077",
            "fax_number": "914-328-6083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "907 E TREMONT AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104604301",
            "telephone_number": "914-328-8077",
            "fax_number": "914-328-6083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRESIDDER",
        "first_name": "JILL",
        "middle_name": "M",
        "credential": "OT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2018-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "011983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JILL",
            "last_name": "STILLMAN",
            "credential": "OT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2018; 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.