Active NPI
Teresa Gibson
- Occupational Therapist
- Brooklyn, NY
National Provider Identifier
1033419478
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 024507-01
- Practice address
- 581 Park PL
Brooklyn, NY 11238-4744 - Phone
- (917) 776-7620
- NPI assigned
- Nov 2, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 005187-1 | NY | |
| Occupational Therapist | 225X00000X | 024507-01 | NY | Primary |
Addresses
Primary practice location
581 Park PL
Brooklyn, NY 11238-4744
Mailing address
1651 Coney Island Ave
Brooklyn, NY 11230-5849
Phone (917) 776-7620
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
| License | State | Type | Specialty |
|---|---|---|---|
| 005187-1 | NY | MD | Occupational Therapy Assistant |
| 024507-01 | NY | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Becon Therapy Services | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Roslyn, NY
- NPI 1205052321
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1288656000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585699200000",
"number": "1033419478",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1651 CONEY ISLAND AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112305849",
"telephone_number": "917-776-7620"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "581 PARK PL",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112384744",
"telephone_number": "917-776-7620"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBSON",
"first_name": "TERESA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-11-02",
"last_updated": "2020-04-01",
"certification_date": "2020-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "NY",
"license": "005187-1",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "024507-01",
"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 Apr 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.