Individual provider Active NPI

Wesley Sanon

  • Occupational Therapist
  • Brooklyn, NY
National Provider Identifier
1043050016
Registry record updated May 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
025905 Issued in NY
Practice address
2579 Ocean Ave
Brooklyn, NY 11229-4552
Phone
(646) 780-0926
NPI assigned
May 28, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 28, 2024

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 025905 NY Primary

Addresses

Primary practice location

2579 Ocean Ave
Brooklyn, NY 11229-4552

Mailing address

821 Sherry Dr
Valley Cottage, NY 10989-2203
Phone (845) 709-5891

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240610002833 NY Practitioner - Occupational Therapist in Private Practice 5890237598 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
025905NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
New York Physical and Occupational Therapy Services, PLLC Occupational Therapist CurrentSince May 25, 2024 Accepting new patients

Locations

2579 Ocean Ave
Fl 3
Brooklyn, NY 11229
Phone (646) 780-0925

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.

NPI Registry JSON

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

{
    "created_epoch": "1716854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716854400000",
    "number": "1043050016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "821 SHERRY DR",
            "city": "VALLEY COTTAGE",
            "state": "NY",
            "postal_code": "109892203",
            "telephone_number": "845-709-5891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2579 OCEAN AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112294552",
            "telephone_number": "646-780-0926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANON",
        "first_name": "WESLEY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-05-28",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "025905",
            "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 May 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.