Venica Phagooram, MS OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

018837-01 Issued in NY

Practice address

14512 111TH Ave
Jamaica, NY 11435-5616

Phone

(917) 379-2868

NPI assigned

Sep 21, 2022

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

Enrolled in NY

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prestige Rehab LLCGroup PAC ID 3375936495, 59 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Prestige Rehab LLC

  • Physical Therapist
  • Colts Neck, NJ
  • NPI 1750032553

  NY, Occupational Therapist

  Medicare reassignment Care Compare group NPD
• Prestige Rehab Ny LLC

  • Physical Therapist
  • New York, NY
  • NPI 1649005778

  Occupational Therapist

  NPD

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

{
    "created_epoch": "1663718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663718400000",
    "number": "1104549609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14512 111TH AVE",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114355616",
            "telephone_number": "917-379-2868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14512 111TH AVE",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114355616",
            "telephone_number": "917-379-2868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAGOORAM",
        "first_name": "VENICA",
        "name_prefix": "Ms.",
        "credential": "MS OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-21",
        "last_updated": "2022-09-21",
        "certification_date": "2022-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "018837-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margaret A Petrosino, LMSW
• Tamara Viktory Petrosyan, O.D.
• Leah Petrucelli
• Grzegorz Petryk, M.D.
• Carol Ann Petti-Garden
• Cindy Pham
• Pharmacy4Humanity
• Pharmex Pharmacy Inc
• Pharmex Pharmacy Inc.
• Rejomon Philip, PT

• Occupational Therapist in Jamaica, NY
• Providers in Jamaica, 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 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.
• 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.