Costantinos Stamboulis, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

020698 Issued in NY

Practice address

2408 32ND St Ste 1002D
Astoria, NY 11102-1139

Phone

(718) 734-2373

Fax

(718) 734-2372

NPI assigned

Oct 9, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Soma Physical and Occupational Therapy PLLCGroup PAC ID 9234538927, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Soma Physical and Occupational Therapy PLLC

  • Physical Therapist
  • Astoria, NY
  • NPI 1144804261

  Occupational Therapist

  Medicare reassignment Care Compare group NPD
• Priority One Therapy PT OT SLP PLLC

  dba @Home Therapy

  • Rehabilitation Practitioner
  • Oceanside, NY
  • NPI 1447517453
  Medicare reassignment NPD

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

{
    "created_epoch": "1475971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620864000000",
    "number": "1003366576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14916 17TH RD",
            "city": "WHITESTONE",
            "state": "NY",
            "postal_code": "113572542",
            "telephone_number": "917-662-3041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2408 32ND ST STE 1002D",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111021139",
            "telephone_number": "718-734-2373",
            "fax_number": "718-734-2372"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2904 Bruckner Blvd",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104652101",
            "country_code": "US",
            "telephone_number": "347-515-6993",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STAMBOULIS",
        "first_name": "COSTANTINOS",
        "name_prefix": "Mr.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-10-09",
        "last_updated": "2021-05-13",
        "certification_date": "2021-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "020698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pericles M Spyropoulos, M.D.
• Anita Srdanovic Parris
• Ssy Acupuncture PLLC
• Mark Stadlen
• Joanne Stalzer, RN
• George Stamboulis, PT, DPT
• Starshine LLC
• Statewide Interventional Pain Medicine, P.C.
• Ioannis Stathopoulos, MD
• Stuart Lance Stauber, MD

• Occupational Therapist in Astoria, NY
• Providers in Astoria, NY by specialty
• Occupational Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2021; 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.