Individual provider Active NPI

Nushaba Badalov, OTR/L

  • Occupational Therapist
  • Brooklyn, NY
National Provider Identifier
1083012629
Registry record updated Jun 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
019325 Issued in NY
Practice address
430 E 8TH St
Apt 705
Brooklyn, NY 11218-4251
Phone
(917) 601-1576
NPI assigned
Dec 14, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 28, 2022

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 019325 NY Primary

Addresses

Primary practice location

430 E 8TH St
Apt 705
Brooklyn, NY 11218-4251

Mailing address

44 Baltusrol Dr
Manalapan, NJ 07726-9325
Phone (917) 601-1576

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221118000921 NJ Practitioner - Occupational Therapist in Private Practice 7517281686 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
At Home by Enhance Therapies LLC Occupational Therapist CurrentSince Jan 1, 2023 Accepting new patients
Link Home Services of NJ LLC CurrentSince Oct 15, 2022 Accepting new patients

Locations

180 Sylvan Ave
Ste 401
Englewood Cliffs, NJ 07632
Phone (347) 841-8943

516 Sylvan Ave
Englewood Cliffs, NJ 07632

411 Hackensack Ave
Ste 200
Hackensack, NJ 07601
Phone (732) 987-3833

400 Route 70
Lakewood, NJ 08701
Phone (732) 802-7512

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": "1418515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656374400000",
    "number": "1083012629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 BALTUSROL DR",
            "city": "MANALAPAN",
            "state": "NJ",
            "postal_code": "077269325",
            "telephone_number": "917-601-1576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 E 8TH ST",
            "address_2": "APT 705",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112184251",
            "telephone_number": "917-601-1576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BADALOV",
        "first_name": "NUSHABA",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-14",
        "last_updated": "2022-06-28",
        "certification_date": "2022-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "019325",
            "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 Jun 28, 2022; 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.