Active NPI
Bryan S Ludin, OTR
- Occupational Therapist
- Commack, NY
National Provider Identifier
1053480632
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 01065
- Practice address
- 159 Indian Head Rd
Commack, NY 11725-2205 - Phone
- (631) 543-4500
- NPI assigned
- Nov 7, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 01065 | NY | Primary |
Addresses
Primary practice location
159 Indian Head Rd
Commack, NY 11725-2205
Mailing address
35 Suncrest Dr
Dix Hills, NY 11746-5736
Phone (516) 680-5410
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01065 | NY | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| United Cerebral Palsy Association of Greater Suffolk, Inc. | Past | Accepting new patients | |
| Ucpa of Suffolk Inc | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Clinic/Center
- Central Islip, NY
- NPI 1609964790
-
- Voluntary or Charitable Agency
- Commack, NY
- NPI 1932296001
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162857600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1244505600000",
"number": "1053480632",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "35 SUNCREST DR",
"city": "DIX HILLS",
"state": "NY",
"postal_code": "117465736",
"telephone_number": "516-680-5410"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "159 INDIAN HEAD RD",
"city": "COMMACK",
"state": "NY",
"postal_code": "117252205",
"telephone_number": "631-543-4500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUDIN",
"first_name": "BRYAN",
"middle_name": "S",
"name_prefix": "Mr.",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-07",
"last_updated": "2009-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "01065",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Commack, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.