Active NPI
Jessie Billings Destefano, OTRL
- Occupational Therapist
- Mount Vernon, NY
National Provider Identifier
1821217522
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 016284-1
- Practice address
- 365 N Fulton Ave
Mount Vernon, NY 10552-3034 - Phone
- (802) 236-2047
- NPI assigned
- Apr 24, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 016284-1 | NY | Primary |
Addresses
Primary practice location
365 N Fulton Ave
Mount Vernon, NY 10552-3034
Mailing address
365 N Fulton Ave
Mount Vernon, NY 10552-3034
Phone (802) 236-2047
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177372800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1515110400000",
"number": "1821217522",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "365 N FULTON AVE",
"city": "MOUNT VERNON",
"state": "NY",
"postal_code": "105523034",
"telephone_number": "802-236-2047"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "365 N FULTON AVE",
"city": "MOUNT VERNON",
"state": "NY",
"postal_code": "105523034",
"telephone_number": "802-236-2047"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DESTEFANO",
"first_name": "JESSIE",
"middle_name": "BILLINGS",
"credential": "OTRL",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-24",
"last_updated": "2018-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "016284-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mount Vernon, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 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.