Jenna Nicole Derleth, OT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

029970 Issued in NY

Practice address

3311 Hylan Blvd
Staten Island, NY 10306-3611

Phone

(718) 448-3210

NPI assigned

Apr 23, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sports Physical Therapy Occupational Therapy and Rehabilitation ServicGroup PAC ID 0446140446, 529 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Sports Physical Therapy Occupational Therapy and Rehabilitation Servic

  • Hand Physical Therapist
  • East Meadow, NY
  • NPI 1770540593

  Occupational Therapist

  Medicare reassignment Care Compare group NPD
• Sports Physical Therapy Occupational Therapy and Rehabilitation Servic

  • Occupational Therapist
  • White Plains, NY
  • NPI 1629825591
  NPD

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

{
    "created_epoch": "1745366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745366400000",
    "number": "1902693807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "972 BRUSH HOLLOW RD FL 4",
            "city": "WESTBURY",
            "state": "NY",
            "postal_code": "115901740",
            "telephone_number": "516-474-2816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3311 HYLAN BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103063611",
            "telephone_number": "718-448-3210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERLETH",
        "first_name": "JENNA",
        "middle_name": "NICOLE",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-23",
        "last_updated": "2025-04-23",
        "certification_date": "2025-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "029970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donna Mae Depola, CASAC, CPP
• Dept of Education,Nyc
• Dean Joseph Derenzo, LMHC
• Patrick Anthony Derespinis Sr., M.D.
• Samantha Deriso, LPN
• Denise Derosa, PT
• Ericka Derose
• Jelani Charles Derrick, RN
• Angel Deruvo, SLP MA CCC
• Bhavita Desai, MD

• Occupational Therapist in Staten Island, NY
• Providers in Staten Island, 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 Apr 23, 2025; 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.