Individual provider Active NPI

Brian Hull, OTR/L

  • Occupational Therapist
  • Latham, NY
National Provider Identifier
1053138156
Registry record updated May 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT25558 Issued in FL
Practice address
578 Loudon Rd
Latham, NY 12110
Phone
(518) 783-1678
NPI assigned
Sep 21, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Rehabilitation Occupational Therapist 225XP0019X 030104 NY
Occupational Therapist 225X00000X OT25558 FL Primary

Addresses

Primary practice location

578 Loudon Rd
Latham, NY 12110

Mailing address

103 E McNab Rd 112
Pompano Beach, FL 33060
Phone (917) 568-5332

Other practice location 1

5459 N Federal Hwy
Fort Lauderdale, FL 33308-3206
Phone (877) 407-3422

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241009004272 FL Practitioner - Occupational Therapist in Private Practice 9133651524 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
030104NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Rehab OT FL LLC Occupational Therapist CurrentSince Sep 1, 2024 Accepting new patients

Locations

3800 W Town Center Blvd
Orlando, FL 32837
Phone (407) 251-8088

3882 Central Sarasota Pkwy
Sarasota, FL 34238
Phone (941) 282-7965

7 Carnegie Plz
Cherry Hill, NJ 08003

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": "1726876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746576000000",
    "number": "1053138156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 E MCNAB RD 112",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "33060",
            "telephone_number": "917-568-5332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "578 LOUDON RD",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "12110",
            "telephone_number": "518-783-1678"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5459 N Federal Hwy",
            "address_purpose": "LOCATION",
            "city": "Fort Lauderdale",
            "state": "FL",
            "postal_code": "333083206",
            "country_code": "US",
            "telephone_number": "877-407-3422",
            "fax_number": "877-407-4329",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HULL",
        "first_name": "BRIAN",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-21",
        "last_updated": "2025-05-07",
        "certification_date": "2025-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "NY",
            "license": "030104",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT25558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Latham, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2025; 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.