Active NPI
Nicole Ellis
- Occupational Therapy Assistant
- Bellmore, NY
National Provider Identifier
1013548478
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 010386-01
- Practice address
- 2868 Beltagh Avenue
Bellmore, NY 11710 - Phone
- (516) 639-4021
- NPI assigned
- Feb 3, 2020
- 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 |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 010386-01 | NY | Primary |
Addresses
Primary practice location
2868 Beltagh Avenue
Bellmore, NY 11710
Mailing address
2868 Beltagh Avenue
Bellmore, NY 11710
Phone (516) 639-4021
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 |
|---|---|---|---|
| 010386-01 | NY | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1580688000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1580688000000",
"number": "1013548478",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2868 BELTAGH AVENUE",
"city": "BELLMORE",
"state": "NY",
"postal_code": "11710",
"telephone_number": "516-639-4021"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2868 BELTAGH AVENUE",
"city": "BELLMORE",
"state": "NY",
"postal_code": "11710",
"telephone_number": "516-639-4021"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLIS",
"first_name": "NICOLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-02-03",
"last_updated": "2020-02-03",
"certification_date": "2020-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "NY",
"license": "010386-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bellmore, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.