Katherine Villa
Individual provider Active NPI Occupational Therapist · New York, NY
NPI 1013228550 · NPPES record last updated Jun 30, 2010
Key facts
- NPI
- 1013228550
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- 014919 (NY)
- Practice address
- 4951 Chambers Street
6TH Floor
New York, NY 10007 - Phone
- (917) 286-5305
- NPI assigned
- Jun 30, 2010
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Occupational Therapist in Private Practice
- Education
- Other, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Exemplary Home Therapy Services LLC
Practice addresses (Care Compare)
1616 Hamilton St
Belleville, NJ 07109-5346
Phone (856) 506-6281
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210628002032 | NJ | Practitioner - Occupational Therapist in Private Practice | 9234530270 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 014919 | NY | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Visiting Therapy Services LLC | Occupational Therapist | Current |
Accepting new patients |
| Exemplary Home Therapy Services LLC | Current |
Accepting new patients | |
| Functional Home Therapy Services LLC | Current |
Accepting new patients |
Locations
271 US Highway 46
Ste H111
Fairfield, NJ 07004
Phone (877) 887-3574
188 Newark Pompton Tpke
Little Falls, NJ 07424
Phone (877) 887-3574
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 014919 | NY | Yes |
Addresses
Primary practice location
4951 Chambers Street
6TH Floor
New York, NY 10007
Mailing address
37-63 B 83Rd St
Apt 403
Jackson Heights, NY 11372
NPI Registry JSON
{
"created_epoch": "1277856000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1277856000000",
"number": "1013228550",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "37-63 B 83RD ST",
"address_2": "APT 403",
"city": "JACKSON HEIGHTS",
"state": "NY",
"postal_code": "11372"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4951 CHAMBERS STREET",
"address_2": "6TH FLOOR",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10007",
"telephone_number": "917-286-5305"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VILLA",
"first_name": "KATHERINE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-06-30",
"last_updated": "2010-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "014919",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
- Vilkelis Chiropractic, PC
- Veronica Sofia Villa-Suarez
- Lucy C Villa-Tineo
- Danielle Villa
- Jill Villa
- Maria Villa
- Nicole Elizabeth Villa
- Sandra E Villa
- Zaskia Villa
- Beatriz Villabona
All providers in New York, NY · Occupational Therapist in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 30, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.