Individual provider Active NPI

Lindsey Elizabeth Kertland, MOTR/L

  • Occupational Therapist
  • Bay Shore, NY
National Provider Identifier
1053615682
Registry record updated Dec 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
015550-1 Issued in NY
Practice address
1428 5TH Ave
Bay Shore, NY 11706-4147
Phone
(631) 665-1900
NPI assigned
Dec 22, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2010

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 015550-1 NY Primary

Addresses

Primary practice location

1428 5TH Ave
Bay Shore, NY 11706-4147

Mailing address

36 Cortelyou St E
Huntington Station, NY 11746-3442
Phone (631) 651-2787

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

LicenseStateTypeSpecialty
015550-1NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Adults and Children With Learning and Developmental Disabilites, Inc. Past Accepting new patients
Acld Kramer Learning Center 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.

NPI Registry JSON

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

{
    "created_epoch": "1292976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292976000000",
    "number": "1053615682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 CORTELYOU ST E",
            "city": "HUNTINGTON STATION",
            "state": "NY",
            "postal_code": "117463442",
            "telephone_number": "631-651-2787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1428 5TH AVE",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117064147",
            "telephone_number": "631-665-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERTLAND",
        "first_name": "LINDSEY",
        "middle_name": "ELIZABETH",
        "credential": "MOTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-12-22",
        "last_updated": "2010-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "015550-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Shore, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.