NPIMap

Organization Active NPI

Integrated Rehab Professionals OT PT PLLC

  • Occupational Therapist
  • Fresh Meadows, NY
National Provider Identifier
1952073074
Registry record updated Oct 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Legal business name
INTEGRATED REHAB PROFESSIONALS OT PT PLLC
Practice address
19801C 67TH Ave Apt 1a
Fresh Meadows, NY 11365-4281
Phone
(347) 851-1400
NPI assigned
Sep 28, 2021
Last updated
Oct 6, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2022

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

Authorized official

Name
Jessica Perez, MS OTR/LNPI 1811334055
Title
Ceo
Phone
(347) 851-1400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X
Occupational TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225X00000X Primary

Addresses

Primary practice location

19801C 67TH Ave Apt 1a
Fresh Meadows, NY 11365-4281

Mailing address

19801C 67TH Ave Apt 1a
Fresh Meadows, NY 11365-4281
Phone (347) 851-1400

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL IntegratedRehabProf Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230227002117 NY Part B Supplier - Clinic/Group Practice 0547633398 Receives reassigned benefits from 5 practitioners
Practice locations: Staten Island, NY; Fresh Meadows, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1632787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665014400000",
    "number": "1952073074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19801C 67TH AVE APT 1A",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113654281",
            "telephone_number": "347-851-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19801C 67TH AVE APT 1A",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113654281",
            "telephone_number": "347-851-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED REHAB PROFESSIONALS OT PT PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-28",
        "last_updated": "2022-10-06",
        "certification_date": "2022-10-06",
        "status": "A",
        "authorized_official_last_name": "PEREZ",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "347-851-1400",
        "authorized_official_credential": "MS OTR/L"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "IntegratedRehabProf",
            "affiliation": "N",
            "endpointDescription": "business email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "19801C 67th Ave Apt 1A",
            "city": "Fresh Meadows",
            "state": "NY",
            "country_code": "US",
            "postal_code": "113654281",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fresh Meadows, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.