Active NPI
Karen Perreault X
- Occupational Therapist
- Syracuse, NY
National Provider Identifier
1104205939
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 006497-1
- Practice address
- 918 James St
Syracuse, NY 13203-2500 - Phone
- (315) 474-1561
- NPI assigned
- May 26, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 006497-1 | NY | Primary |
Addresses
Primary practice location
918 James St
Syracuse, NY 13203-2500
Mailing address
562 W Seneca Tpke
Syracuse, NY 13207-2645
Phone (516) 902-2508
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 006497-1 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 006497-1 | NY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1432598400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1432598400000",
"number": "1104205939",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "562 W SENECA TPKE",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132072645",
"telephone_number": "516-902-2508"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "918 JAMES ST",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132032500",
"telephone_number": "315-474-1561"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PERREAULT",
"first_name": "KAREN",
"name_prefix": "Mrs.",
"name_suffix": "X",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-05-26",
"last_updated": "2015-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "006497-1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "006497-1",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Syracuse, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.