Individual provider Active NPI

Angelica Stark, MSOT, OTR/L

  • Occupational Therapist
  • New York, NY
National Provider Identifier
1104764059
Registry record updated Mar 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
031031 Issued in NY
Practice address
976 Amsterdam Ave
New York, NY 10025-2201
Phone
(212) 222-9305
Fax
(212) 222-8129
NPI assigned
Mar 23, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2026

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 031031 NY Primary

Addresses

Primary practice location

976 Amsterdam Ave
New York, NY 10025-2201

Mailing address

1555 2ND Ave Apt 4F
New York, NY 10028-3909
Phone (917) 701-0318

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260407000206 NY Practitioner - Occupational Therapist in Private Practice 6901381573 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2026
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
RB Physical and Occupational Therapy, PLLCGroup PAC ID 5294870226, 312 clinicians

Practice addresses (Care Compare)

976 Amsterdam Ave
New York, NY 10025-2201
Phone (212) 222-9305

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
RB Physical and Occupational Therapy PLLC Occupational Therapist CurrentSince Mar 24, 2026 Accepting new patients
One on One Physical Therapy Services PLLC PastSince Mar 24, 2026 Accepting new patients

Locations

976 Amsterdam Ave
New York, NY 10025
Phone (212) 222-9305

231 Beach 116th St
Rockaway Park, NY 11694
Phone (718) 474-2224

Organizations & group practices 2

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": "1774224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774224000000",
    "number": "1104764059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1555 2ND AVE APT 4F",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100283909",
            "telephone_number": "917-701-0318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "976 AMSTERDAM AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100252201",
            "telephone_number": "212-222-9305",
            "fax_number": "212-222-8129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARK",
        "first_name": "ANGELICA",
        "credential": "MSOT, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-03-23",
        "last_updated": "2026-03-23",
        "certification_date": "2026-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "031031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2026; 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.