Individual provider Active NPI

Jacaranda Chapa, OTR/L

  • Occupational Therapist
  • New York, NY
National Provider Identifier
1841582715
Registry record updated Feb 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
016704 Issued in NY
Practice address
460 W 34TH St
9TH Floor
New York, NY 10001-2320
Phone
(646) 812-1695
NPI assigned
May 10, 2011
Last updated
Feb 23, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 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 016704 NY Primary

Addresses

Primary practice location

460 W 34TH St
9TH Floor
New York, NY 10001-2320

Mailing address

460 W 34TH St
9TH Floor
New York, NY 10001-2320
Phone (646) 812-1695

Other names 1

  • Jacaranda Chapa Josephs Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110602000569 NY Practitioner - Occupational Therapist in Private Practice 5496932253 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Mercy College, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Healthcare IncGroup PAC ID 1254233158, 58 clinicians

Practice addresses (Care Compare)

3060 E Tremont Ave
Bronx, NY 10461-5726
Phone (718) 239-1790

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Young Adult Institute, Inc. CurrentSince Oct 7, 2019 Accepting new patients
Premier Healthcare, Inc. CurrentSince May 9, 2011 Accepting new patients
Premier Healthcare, Inc. CurrentSince May 9, 2011 Accepting new patients

Locations

21111 Northern Blvd
Bayside, NY 11361
Phone (212) 563-7474

3060 E Tremont Ave
Bronx, NY 10461
Phone (718) 239-1790

3060 E Tremont Ave
#2
Bronx, NY 10461

175 Remsen St
Brooklyn, NY 11201
Phone (718) 303-1300

220 E 42nd St
Fl 8
New York, NY 10017
Phone (212) 273-2761

460 W 34th St
Fl 9
New York, NY 10001
Phone (212) 273-6515

Interoperability endpoints

  • Direct secure messaging: jacaranda.josephs.p1@direct.premierhealthcare.nextgenshare.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1304985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519344000000",
    "number": "1841582715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 W 34TH ST",
            "address_2": "9TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100012320",
            "telephone_number": "646-812-1695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 W 34TH ST",
            "address_2": "9TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100012320",
            "telephone_number": "646-812-1695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAPA",
        "first_name": "JACARANDA",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-10",
        "last_updated": "2018-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "016704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACARANDA",
            "last_name": "CHAPA JOSEPHS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.