Jesse Matteson, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

020866 Issued in NY

Practice address

5651 Pavilion Way
Fort Ann, NY 12827-2515

Phone

(518) 588-7100

NPI assigned

Sep 19, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Jesse Dashnaw Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1474243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474243200000",
    "number": "1811445802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5651 PAVILION WAY",
            "city": "FORT ANN",
            "state": "NY",
            "postal_code": "128272515",
            "telephone_number": "518-588-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5651 PAVILION WAY",
            "city": "FORT ANN",
            "state": "NY",
            "postal_code": "128272515",
            "telephone_number": "518-588-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTESON",
        "first_name": "JESSE",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-19",
        "last_updated": "2016-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "020866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSE",
            "last_name": "DASHNAW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Emmett Rhett Eubanks, LCSW
• Fort Ann Central School
• Fort Ann Rescue Squad Inc
• Suzanne Marie Loparnos, M.S., CCC-SLP
• Rachel McQueen, M.S., LCAT, MT-BC
• Robert Vincent Morse II, PSY.D.
• Debra Darlene Newton, LPN
• Keri Paige, RN
• Sharon Virginia Pavelchak

• Occupational Therapist in Fort Ann, NY
• Providers in Fort Ann, NY by specialty
• Occupational Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2016; 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.