Individual provider Active NPI

Jessica Betancourt, OTR/L

  • Hand Occupational Therapist
  • New York, NY
National Provider Identifier
1942856406
Registry record updated Mar 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hand Occupational TherapistTaxonomy code 225XH1200X
License
023645 Issued in NY
Practice address
611 Broadway RM 901
New York, NY 10012-2630
Phone
(212) 473-0011
NPI assigned
Aug 12, 2019
Last updated
Mar 26, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 023645 NY
Hand Occupational Therapist 225XH1200X 023645 NY Primary

Addresses

Primary practice location

611 Broadway RM 901
New York, NY 10012-2630

Mailing address

PO Box 147
New York, NY 10272-0147

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191028001677 NY Practitioner - Occupational Therapist in Private Practice 2860724622 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
RB Physical and Occupational Therapy, PLLCGroup PAC ID 5294870226, 312 clinicians

Practice addresses (Care Compare)

24 Saw Mill River Rd
Suite 204
Hawthorne, NY 10532-1555
Phone (914) 631-6969

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
023645NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
United Cerebral Palsy of New York City Inc CurrentSince Sep 3, 2019 Accepting new patients
RB Physical and Occupational Therapy PLLC Occupational Therapist CurrentSince Jun 24, 2022 Accepting new patients

Locations

981 US Highway 22
Fl 2
Bridgewater, NJ 08807
Phone (908) 231-0511

110 Elmwood Ave
Brooklyn, NY 11230
Phone (718) 859-5420

175 Lawrence Ave
Brooklyn, NY 11230
Phone (718) 436-7600

4013 Avenue U
Brooklyn, NY 11234
Phone (718) 692-0949

24 Saw Mill River Rd
Ste 204
Hawthorne, NY 10532
Phone (914) 592-9600

80 Maiden Ln
Fl 12
New York, NY 10038

1441 South Ave
Ste 704
Staten Island, NY 10314
Phone (718) 303-9777

Interoperability endpoints

  • Direct secure messaging: jessica.betancourt.p2@direct.ucpnyc.nextgenshare.com

Organizations & group practices 2

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": "1565568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585180800000",
    "number": "1942856406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 147",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "102720147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 BROADWAY RM 901",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100122630",
            "telephone_number": "212-473-0011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BETANCOURT",
        "first_name": "JESSICA",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-12",
        "last_updated": "2020-03-26",
        "certification_date": "2020-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "023645",
            "primary": false
        },
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "NY",
            "license": "023645",
            "primary": true
        }
    ],
    "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 Mar 26, 2020; 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.