NPIMap

Organization Active NPI

Optimized Independence OT PLLC

  • Occupational Therapist
  • Roslyn, NY
National Provider Identifier
1093235707
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
017794 Issued in NY
Legal business name
OPTIMIZED INDEPENDENCE OT PLLC
Practice address
78 Reed Dr
Roslyn, NY 11576-3216
Phone
(917) 749-6635
NPI assigned
Jun 23, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Alex Suen, OTR/LNPI 1326380403
Title
Co-Owner/Vice-President
Phone
(917) 749-6635

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 019271 NY
Occupational Therapist 225X00000X 017794 NY Primary

Addresses

Primary practice location

78 Reed Dr
Roslyn, NY 11576-3216

Mailing address

78 Reed Dr
Roslyn, NY 11576-3216
Phone (917) 749-6635

Other identifiers 2

IdentifierTypeStateIssuer
1326380403OtherNPPES
1861898538OtherNPPES

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170823002702 NY Part B Supplier - Physical/Occupational Therapy Group in Private Practice 4183996390 Receives reassigned benefits from 29 practitioners
Practice locations: Roslyn, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 33

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 33

NPI Registry JSON

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

{
    "created_epoch": "1498176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1093235707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "78 REED DR",
            "city": "ROSLYN",
            "state": "NY",
            "postal_code": "115763216",
            "telephone_number": "917-749-6635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "78 REED DR",
            "city": "ROSLYN",
            "state": "NY",
            "postal_code": "115763216",
            "telephone_number": "917-749-6635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMIZED INDEPENDENCE OT PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-23",
        "last_updated": "2022-07-21",
        "certification_date": "2020-12-01",
        "status": "A",
        "authorized_official_last_name": "SUEN",
        "authorized_official_first_name": "ALEX",
        "authorized_official_title_or_position": "CO-OWNER/VICE-PRESIDENT",
        "authorized_official_telephone_number": "917-749-6635",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "019271",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "017794",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPPES",
            "identifier": "1326380403",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPPES",
            "identifier": "1861898538",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roslyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.