Individual provider Active NPI

Valerie Khodorkovskiy, OTRL

  • Occupational Therapist
  • Brooklyn, NY
National Provider Identifier
1003508714
Registry record updated May 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
026109-01 Issued in NY
Practice address
2781 Shell Rd Ste 101
Brooklyn, NY 11223-6142
Phone
(718) 648-1234
Fax
(718) 648-1239
NPI assigned
May 22, 2023
Last updated
May 22, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 026109-01 NY Primary

Addresses

Primary practice location

2781 Shell Rd Ste 101
Brooklyn, NY 11223-6142

Mailing address

2781 Shell Rd Ste 101
Brooklyn, NY 11223-6142
Phone (718) 648-1234

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230623000744 NY Practitioner - Occupational Therapist in Private Practice 5294193280 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Precision Care Medical PCGroup PAC ID 6901185214, 12 clinicians
Ascend Medicine PLLCGroup PAC ID 6305372467, 4 clinicians

Practice addresses (Care Compare)

2781 Shell Rd
Suite 101
Brooklyn, NY 11223-6142
Phone (718) 648-1234

360 Merrick Rd
Suite 310
Lynbrook, NY 11563-2526
Phone (516) 724-8444

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
026109-01NYMDOccupational Therapist
026109NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Ascend Medicine PLLC CurrentSince Dec 1, 2024 Accepting new patients

Locations

360 Merrick Rd
Ste 310
Lynbrook, NY 11563
Phone (516) 724-8444

Networks

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

Interoperability endpoints

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

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": "1684713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684713600000",
    "number": "1003508714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2781 SHELL RD STE 101",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112236142",
            "telephone_number": "718-648-1234",
            "fax_number": "718-648-1239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2781 SHELL RD STE 101",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112236142",
            "telephone_number": "718-648-1234",
            "fax_number": "718-648-1239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHODORKOVSKIY",
        "first_name": "VALERIE",
        "credential": "OTRL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-22",
        "last_updated": "2023-05-22",
        "certification_date": "2023-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "026109-01",
            "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 May 22, 2023; 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.