Individual provider Active NPI

Alina Yusupova

  • Pediatric Occupational Therapist
  • Rego Park, NY
National Provider Identifier
1023419397
Registry record updated Sep 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
019056 Issued in NY
Practice address
9932 64TH Rd
Rego Park, NY 11374-2646
Phone
(646) 245-1734
NPI assigned
Sep 5, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 019056 NY Primary

Addresses

Primary practice location

9932 64TH Rd
Rego Park, NY 11374-2646

Mailing address

9932 64TH Rd
Rego Park, NY 11374-2646
Phone (646) 245-1734

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150317002657 NY Practitioner - Occupational Therapist in Private Practice 4385961002 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PT and OT for Senior Rehab at Home PLLCGroup PAC ID 2668711573, 97 clinicians

Practice addresses (Care Compare)

171 Kings Hwy
Brooklyn, NY 11223-1023
Phone (914) 837-6538

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019056NYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
PT and OT for Senior Rehab at Home PLLC CurrentSince Jan 1, 2025 Accepting new patients
Ats Rehab OT & PT & SLP PLLC CurrentSince Aug 24, 2017 Accepting new patients
Link Home Therapy Services of Ny-PT OT SLP PLLC CurrentSince Mar 11, 2019 Accepting new patients

Locations

180 Sylvan Ave
Ste 4
Englewood Cliffs, NJ 07632
Phone (347) 841-8943

1105 E County Line Rd
Ste 213
Lakewood, NJ 08701

171 Kings Hwy
Brooklyn, NY 11223
Phone (877) 722-7700

8008 45th Ave
Ofc
Elmhurst, NY 11373

10825 Horace Harding Expy
Flushing, NY 11368
Phone (516) 216-4108

475 Northern Blvd
Ste 37
Great Neck, NY 11021
Phone (516) 344-0023

274 W Broadway
Long Beach, NY 11561
Phone (516) 431-1400

108 S Franklin Ave
Ste 10
Valley Stream, NY 11580

Organizations & group practices 4

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": "1409875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409875200000",
    "number": "1023419397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9932 64TH RD",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113742646",
            "telephone_number": "646-245-1734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9932 64TH RD",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113742646",
            "telephone_number": "646-245-1734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YUSUPOVA",
        "first_name": "ALINA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-05",
        "last_updated": "2014-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NY",
            "license": "019056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rego Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2014; 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.