Kaitlin Rose Neiswenter, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

028283 Issued in NY

Practice address

100 Duffy Ave
Hicksville, NY 11801-3636

Phone

(631) 600-3029

NPI assigned

Aug 30, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1693353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693526400000",
    "number": "1093590655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 BEACH 134TH ST",
            "city": "BELLE HARBOR",
            "state": "NY",
            "postal_code": "116941440",
            "telephone_number": "347-804-9667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 DUFFY AVE",
            "city": "HICKSVILLE",
            "state": "NY",
            "postal_code": "118013636",
            "telephone_number": "631-600-3029"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6800 Jericho Tpke",
            "address_purpose": "LOCATION",
            "city": "Syosset",
            "state": "NY",
            "postal_code": "117914436",
            "country_code": "US",
            "telephone_number": "516-393-5966",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEISWENTER",
        "first_name": "KAITLIN",
        "middle_name": "ROSE",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-30",
        "last_updated": "2023-09-01",
        "certification_date": "2023-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "028283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapist in Hicksville, NY
• Providers in Hicksville, NY by specialty
• Occupational Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2023; 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.