Individual provider Active NPI

Kristen Tisch

  • Occupational Therapist
  • Brooklyn, NY
National Provider Identifier
1013634583
Registry record updated Oct 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
027191 Issued in NY
Practice address
8746 20TH Ave FL 2
Brooklyn, NY 11214-4802
Phone
(718) 238-7451
NPI assigned
Oct 25, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 25, 2022

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 027191 NY Primary

Addresses

Primary practice location

8746 20TH Ave FL 2
Brooklyn, NY 11214-4802

Mailing address

103 5TH Ave Unit 2
Brooklyn, NY 11217-3228
Phone (631) 664-2490

Other practice location 1

706 Quincy St
Brooklyn, NY 11221-2210
Phone (718) 443-3440

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
027191NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sensory Freeway Therapy Services OT, PT and SLP, PLLC CurrentSince Oct 30, 2022 Accepting new patients
New York Child Resource Center Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1666656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666656000000",
    "number": "1013634583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 5TH AVE UNIT 2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112173228",
            "telephone_number": "631-664-2490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8746 20TH AVE FL 2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112144802",
            "telephone_number": "718-238-7451"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "706 Quincy St",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112212210",
            "country_code": "US",
            "telephone_number": "718-443-3440",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TISCH",
        "first_name": "KRISTEN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-25",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "027191",
            "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 Oct 25, 2022; 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.