Individual provider Active NPI

Adam J Samuels, OTR/L

  • Occupational Therapist
  • Rockville Centre, NY
National Provider Identifier
1083973713
Registry record updated May 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
017311 Issued in NY
Practice address
265 Sunrise Hwy # 121
Rockville Centre, NY 11570-4912
Phone
(516) 728-7937
NPI assigned
May 15, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 6, 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 017311 NY Primary

Addresses

Primary practice location

265 Sunrise Hwy # 121
Rockville Centre, NY 11570-4912

Mailing address

25204 60TH Ave
Little Neck, NY 11362-2441

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240515004337 NY Practitioner - Occupational Therapist in Private Practice 2860833209 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PT and OT for Senior Rehab at Home PLLCGroup PAC ID 2668711573, 97 clinicians

Practice addresses (Care Compare)

171 Kings Hwy
Brooklyn, NY 11223-1023
Phone (914) 837-6538

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
PT and OT for Senior Rehab at Home PLLC CurrentSince May 1, 2024 Accepting new patients

Locations

171 Kings Hwy
Brooklyn, NY 11223
Phone (877) 722-7700

8008 45th Ave
Ofc
Elmhurst, NY 11373

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": "1337040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714953600000",
    "number": "1083973713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25204 60TH AVE",
            "city": "LITTLE NECK",
            "state": "NY",
            "postal_code": "113622441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "265 SUNRISE HWY # 121",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115704912",
            "telephone_number": "516-728-7937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUELS",
        "first_name": "ADAM",
        "middle_name": "J",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-05-15",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "017311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville Centre, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.