Individual provider Active NPI

Elena Stefanovich, OTR

  • Occupational Therapist
  • Brooklyn, NY
National Provider Identifier
1093204976
Registry record updated May 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
022546 Issued in NY
Practice address
2705 Mermaid Ave
Brooklyn, NY 11224-2005
Phone
(718) 333-1024
NPI assigned
May 6, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2018

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 022546 NY Primary

Addresses

Primary practice location

2705 Mermaid Ave
Brooklyn, NY 11224-2005

Mailing address

578 Mayfair Dr S FL 2
Brooklyn, NY 11234-6413

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180522001117 NY Practitioner - Occupational Therapist in Private Practice 9234494220 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Mercy College, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Core Therapy Services PT OT PLLCGroup PAC ID 4587041512, 28 clinicians

Practice addresses (Care Compare)

2003 Coney Island Ave
Brooklyn, NY 11223-2328
Phone (347) 394-1600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rehab on Wheels OT PT PLLC Occupational Therapist CurrentSince Apr 14, 2018 Accepting new patients
Golden Touch Physical Therapy, PLLC CurrentSince May 1, 2018 Accepting new patients
Core Therapy Services PT OT PLLC Occupational Therapist CurrentSince Sep 11, 2023 Accepting new patients
Road to Recovery Physical Therapy, P.C. Occupational Therapist CurrentSince May 1, 2018 Accepting new patients
Prokinetics Physical Therapy P.C. PastSince Jul 5, 2023 Accepting new patients

Locations

2876 W 27th St
Brooklyn, NY 11224
Phone (718) 265-2222

2003 Coney Island Ave
Brooklyn, NY 11223
Phone (347) 394-1600

8419 Bay Pkwy
Brooklyn, NY 11214
Phone (718) 259-0199

174 Bay 29th St
Ste C1
Brooklyn, NY 11214
Phone (646) 750-4455

535 Flushing Ave
Brooklyn, NY 11205
Phone (781) 488-7272

2705 Mermaid Ave
Brooklyn, NY 11224
Phone (718) 265-2222

Organizations & group practices 5

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": "1525564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525564800000",
    "number": "1093204976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "578 MAYFAIR DR S FL 2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112346413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2705 MERMAID AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112242005",
            "telephone_number": "718-333-1024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEFANOVICH",
        "first_name": "ELENA",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-06",
        "last_updated": "2018-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "022546",
            "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 May 6, 2018; 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.