Individual provider Active NPI

Bernard Samuel Bucholz, OTR

  • Community Health Worker
  • Brooklyn, NY
National Provider Identifier
1003077686
Registry record updated Nov 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
License
014378 Issued in NY
Practice address
1225 Ocean Parkway
Apt 5M
Brooklyn, NY 11230-5162
Phone
(718) 253-2972
NPI assigned
Jun 17, 2008
Last updated
Nov 22, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X 014378 NY Primary

Addresses

Primary practice location

1225 Ocean Parkway
Apt 5M
Brooklyn, NY 11230-5162

Mailing address

1225 Ocean Parkway
Apt 5M
Brooklyn, NY 11230-5162
Phone (718) 253-2972

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161017000341 NY Practitioner - Occupational Therapist in Private Practice 7214225762 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rehabilitation Associates PT and OT, PLLCGroup PAC ID 6305015421, 7 clinicians

Practice addresses (Care Compare)

2072 Ocean Ave
Apt 101
Brooklyn, NY 11230-7384
Phone (718) 616-1450

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rehabilitation Associates PT and OT, PLLC CurrentSince Sep 1, 2016 Accepting new patients
Oda Primary Health Care Network, Inc. Past Accepting new patients

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GIAGAA/Endpoint/GIAGAA

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": "1213660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227312000000",
    "number": "1003077686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 OCEAN PARKWAY",
            "address_2": "APT 5M",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112305162",
            "telephone_number": "718-253-2972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 OCEAN PARKWAY",
            "address_2": "APT 5M",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112305162",
            "telephone_number": "718-253-2972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCHOLZ",
        "first_name": "BERNARD",
        "middle_name": "SAMUEL",
        "name_prefix": "Mr.",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-17",
        "last_updated": "2008-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "NY",
            "license": "014378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2008; 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.