Active NPI
Jessica Fertig, ATR-BC, LCAT
- Art Therapist
- New York, NY
National Provider Identifier
1992410054
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Art Therapist
- License
- 001501
- Practice address
- 188 W 88TH St
New York, NY 10024-2402 - Phone
- (212) 787-7120
- NPI assigned
- Jan 23, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Art Therapist | 221700000X | 001501 | NJ | Primary |
Addresses
Primary practice location
188 W 88TH St
New York, NY 10024-2402
Mailing address
302 W 91St St Apt 2
New York, NY 10024-1011
Phone (212) 787-7120
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jfertig@spop.org | Direct |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 001501 | NJ | MD | Art Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Service Program for Older People, Inc | Current | Accepting new patients | |
| Service Program for Older People | Past | Accepting new patients |
Locations
188 W 88th St
New York, NY 10024
Phone 2127877120 ext. 139
302 W 91st St
Apt 2
New York, NY 10024
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 and National Provider Directory roles.
-
- Geriatric Psychiatry Physician
- New York, NY
- NPI 1740211143
-
- Community/Behavioral Health Agency
- New York, NY
- NPI 1831644657
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1674432000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1674432000000",
"number": "1992410054",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "302 W 91ST ST APT 2",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100241011",
"telephone_number": "212-787-7120"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "188 W 88TH ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100242402",
"telephone_number": "212-787-7120"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FERTIG",
"first_name": "JESSICA",
"credential": "ATR-BC, LCAT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-01-23",
"last_updated": "2023-01-23",
"certification_date": "2023-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "221700000X",
"taxonomy_group": "",
"desc": "Art Therapist",
"state": "NJ",
"license": "001501",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jfertig@spop.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "188 W 88th St",
"city": "New York",
"state": "NY",
"country_code": "US",
"postal_code": "100242402",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 Jan 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.