Individual provider Active NPI

Jaquante M Lance, OTR

  • Occupational Therapist
  • Staten Island, NY
National Provider Identifier
1831745082
Registry record updated Aug 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
023682 Issued in NY
Practice address
3391 Richmond Ave
Staten Island, NY 10312-2025
Phone
(910) 489-4473
NPI assigned
Aug 14, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2019

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 023682 NY Primary

Addresses

Primary practice location

3391 Richmond Ave
Staten Island, NY 10312-2025

Mailing address

740 Empire Blvd Apt 2S
Brooklyn, NY 11213-5364
Phone (910) 489-4473

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address j.lance@tppnyc.com Direct

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
023682NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Civil Physical Therapy, PLLC CurrentSince May 18, 2021 Accepting new patients
Esd PT OT & SLP PLLC Occupational Therapist CurrentSince Oct 1, 2020 Accepting new patients
New York Physical and Occupational Therapy Services, PLLC Occupational Therapist CurrentSince Oct 1, 2020 Accepting new patients

Locations

5881 Glenridge Dr
Ste 220
Sandy Springs, GA 30328
Phone (404) 481-3732

2632 Atlantic Ave
Brooklyn, NY 11207
Phone (718) 473-3803

2579 Ocean Ave
Fl 3
Brooklyn, NY 11229
Phone (646) 780-0925

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": "1565740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565740800000",
    "number": "1831745082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 EMPIRE BLVD APT 2S",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112135364",
            "telephone_number": "910-489-4473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3391 RICHMOND AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103122025",
            "telephone_number": "910-489-4473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANCE",
        "first_name": "JAQUANTE",
        "middle_name": "M",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-14",
        "last_updated": "2019-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "023682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "j.lance@tppnyc.com",
            "affiliation": "N",
            "endpointDescription": "The Perfect Playground",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3391 Richmond Ave",
            "city": "Staten Island",
            "state": "NY",
            "country_code": "US",
            "postal_code": "103122025",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2019; 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.