Bruce Douglas, OTR LICENSE

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

005500 Issued in NY

Practice address

4319 Church Ave
Brooklyn, NY 11203-3101

Phone

(718) 978-3186

Fax

(718) 221-5530

NPI assigned

Apr 17, 2007

Last updated

Aug 1, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

State University of New York Downstate Medical Center, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Practice roles

Locations

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.

• Douglas O T Services P.C.

  dba Occupational Therapy Services

  • Occupational Therapist
  • Brooklyn, NY
  • NPI 1154441129
  Medicare reassignment NPD Authorized official
• Hands on Physical Therapy, PC

  • Physical Therapist
  • Astoria, NY
  • NPI 1396783221
  NPD (past)
• Maspeth Roura Medical Care PC

  • Internal Medicine Physician
  • Maspeth, NY
  • NPI 1588851745
  NPD (past)

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375315200000",
    "number": "1023233558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 MIDWOOD ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112031103",
            "telephone_number": "718-978-3188",
            "fax_number": "718-221-5530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4319 CHURCH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112033101",
            "telephone_number": "718-978-3186",
            "fax_number": "718-221-5530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "BRUCE",
        "name_prefix": "Mr.",
        "credential": "OTR LICENSE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-17",
        "last_updated": "2013-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "005500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachid Douglas Louis
• Douglas O T Services P.C. (Occupational Therapy Services)
• Albert S Douglas, MD
• Angela Douglas
• Bernadette Polite Douglas
• India Renee Douglas, LMSW
• Lanna Douglas
• Lindsey Caroline Douglas, MD
• Lorna Douglas
• Manushka C Douglas, LPN

• Occupational Therapist in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Occupational Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2013; 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.