Individual provider Active NPI

Jessica Lyn Chiusano

  • Specialist
  • Sayville, NY
National Provider Identifier
1972866416
Registry record updated Jun 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
211483032 Issued in NY
Practice address
44 Overton Ave
44 Overton Ave
Sayville, NY 11782-2416
Phone
(631) 871-4902
NPI assigned
Jun 20, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 211483032 NY Primary

Addresses

Primary practice location

44 Overton Ave
44 Overton Ave
Sayville, NY 11782-2416

Mailing address

44 Overton Ave
44 Overton Ave
Sayville, NY 11782-2416
Phone (631) 871-4902

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
211483032NYMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1340150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340150400000",
    "number": "1972866416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 OVERTON AVE",
            "address_2": "44 OVERTON AVE",
            "city": "SAYVILLE",
            "state": "NY",
            "postal_code": "117822416",
            "telephone_number": "631-871-4902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 OVERTON AVE",
            "address_2": "44 OVERTON AVE",
            "city": "SAYVILLE",
            "state": "NY",
            "postal_code": "117822416",
            "telephone_number": "631-871-4902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIUSANO",
        "first_name": "JESSICA",
        "middle_name": "LYN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-20",
        "last_updated": "2012-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "211483032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sayville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.