Individual provider Active NPI

Jenny Occiano

  • Physical Therapist
  • New York, NY
National Provider Identifier
1932554698
Registry record updated May 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
039222 Issued in NY
Practice address
4015 81St Street, Apt A49
Elmhurst
New York, NY 11373
Phone
(551) 265-5872
NPI assigned
May 2, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 2, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 039222 NY Primary
Physical Therapy Assistant 225200000X 008294 NY

Addresses

Primary practice location

4015 81St Street, Apt A49
Elmhurst
New York, NY 11373

Mailing address

4015 81St Street, Apt A49
Elmhurst
New York, NY 11373
Phone (551) 265-5872

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201207001520 NY Practitioner - Physical Therapist in Private Practice 7618389123 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

Great Neck, NY 11021
Phone (212) 842-0080

1110 2ND Ave
New York, NY 10022-2093

1110 2ND Ave
Suite 302
New York, NY 10022-2007

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
039222NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Outreach Physical and Occupational Therapy & Speech Rehabilitation, PLLC Physical Therapist CurrentSince Nov 20, 2020 Accepting new patients

Locations

3 Grace Ave
Ste 119
Great Neck, NY 11021
Phone (212) 842-0080

Organizations & group practices 1

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": "1462147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462147200000",
    "number": "1932554698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4015 81ST STREET, APT A49",
            "address_2": "ELMHURST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "11373",
            "telephone_number": "551-265-5872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4015 81ST STREET, APT A49",
            "address_2": "ELMHURST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "11373",
            "telephone_number": "551-265-5872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OCCIANO",
        "first_name": "JENNY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-02",
        "last_updated": "2016-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "039222",
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NY",
            "license": "008294",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 May 2, 2016; 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.