Individual provider Active NPI

Larisa V Shamray

  • Occupational Therapist
  • Brooklyn, NY
National Provider Identifier
1013556950
Registry record updated Dec 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
024324 Issued in NY
Practice address
2955 Brighton 4TH St
Brooklyn, NY 11235-8533
Phone
(718) 509-4909
NPI assigned
Dec 23, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 23, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 024324 NY
Occupational Therapist 225X00000X 024324 NY Primary

Addresses

Primary practice location

2955 Brighton 4TH St
Brooklyn, NY 11235-8533

Mailing address

1360 Ocean Ave Apt 3N
Brooklyn, NY 11230-3258

Other practice location 1

704 Avenue X Fl 2
Brooklyn, NY 11235-6121
Phone (347) 307-2350

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

LicenseStateTypeSpecialty
024324NYMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1577059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577059200000",
    "number": "1013556950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1360 OCEAN AVE APT 3N",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112303258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2955 BRIGHTON 4TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112358533",
            "telephone_number": "718-509-4909"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "704 Avenue X Fl 2",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112356121",
            "country_code": "US",
            "telephone_number": "347-307-2350",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAMRAY",
        "first_name": "LARISA",
        "middle_name": "V",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-23",
        "last_updated": "2019-12-23",
        "certification_date": "2019-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NY",
            "license": "024324",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "024324",
            "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 Dec 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.