Individual provider Active NPI

Emerson Krasnickas, OT

  • Occupational Therapist
  • Newtown, CT
National Provider Identifier
1023828316
Registry record updated Jan 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
006575 Issued in CT
Practice address
18 Grand PL
Newtown, CT 06470-2114
Phone
(203) 770-4440
Fax
(855) 678-8887
NPI assigned
Jan 9, 2025
Last updated
Jan 9, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2025

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 006575 CT Primary

Addresses

Primary practice location

18 Grand PL
Newtown, CT 06470-2114

Mailing address

18 Grand PL
Newtown, CT 06470-2114
Phone (203) 770-4440

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250211002671 CT Practitioner - Occupational Therapist in Private Practice 2961932694 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prestige Rehab CT PLLCGroup PAC ID 7416487152, 14 clinicians

Practice addresses (Care Compare)

36 Russ St
FL 3
Hartford, CT 06106-1520
Phone (855) 678-8887

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6575CTMDGeneral Practice Dentistry
006575CTMDCritical Care Medicine Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Prestige Rehab CT PLLC CurrentSince Feb 3, 2025 Accepting new patients

Locations

36 Russ St
Fl 3
Hartford, CT 06106
Phone (301) 785-2099

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1736380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736380800000",
    "number": "1023828316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 GRAND PL",
            "city": "NEWTOWN",
            "state": "CT",
            "postal_code": "064702114",
            "telephone_number": "203-770-4440",
            "fax_number": "855-678-8887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 GRAND PL",
            "city": "NEWTOWN",
            "state": "CT",
            "postal_code": "064702114",
            "telephone_number": "203-770-4440",
            "fax_number": "855-678-8887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRASNICKAS",
        "first_name": "EMERSON",
        "credential": "OT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-09",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CT",
            "license": "006575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newtown, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2025; 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.