Nicole White

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

027206 Issued in NY

Practice address

70 N Country Rd Ste 103
Port Jefferson, NY 11777-2161

Phone

(631) 938-1565

Fax

(321) 865-1179

NPI assigned

Oct 4, 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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Professional Occupational and Physical Therapy, PLLCGroup PAC ID 3779873401, 497 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

77.16 of 100Reported as group

Quality

70

Improvement activities

40

Cost

78.87

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Professional Occupational & Physical Therapy, PLLC

  • Occupational Therapist
  • Rockville Centre, NY
  • NPI 1205296902
  Medicare reassignment Care Compare group NPD
• Sports Physical Therapy Occupational Therapy and Rehabilitation Servic

  • Hand Physical Therapist
  • East Meadow, NY
  • NPI 1770540593

  Occupational Therapist

  Medicare reassignment NPD
• Professional Occupational & Physical Therapy, PLLC

  • Occupational Therapist
  • Whitestone, NY
  • NPI 1487104261
  NPD
• Sports Physical Therapy Occupational Therapy and Rehabilitation Servic

  • Occupational Therapist
  • White Plains, NY
  • NPI 1629825591
  NPD
• Professional Occupational & Physical Therapy, PLLC

  • Occupational Therapist
  • Randolph, NJ
  • NPI 1104376680
  NPD

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

{
    "created_epoch": "1664841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664841600000",
    "number": "1114642022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "576 BROADHOLLOW RD",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117475002",
            "telephone_number": "631-359-5859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 N COUNTRY RD STE 103",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117772161",
            "telephone_number": "631-938-1565",
            "fax_number": "321-865-1179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "NICOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-04",
        "last_updated": "2022-10-04",
        "certification_date": "2022-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "027206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROFESSIONAL OCCUPATIONAL PHYSICAL THERAPY, PLLC",
            "identifier": "1487104261",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "credentialing@professionalpt.com",
            "affiliation": "N",
            "endpointDescription": "Correspondence email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "576 Broadhollow Rd",
            "city": "Melville",
            "state": "NY",
            "country_code": "US",
            "postal_code": "117475002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Christopher Westphal Weidler, D.C.
• Jillian Susanne Weiss, DO
• Lois L Weiss, DDS
• Carolyn Werr
• Sung Whang, MD
• Ian Ralph Whiteside, M.D.
• Barbara J Wickenhauser
• Michelle K Wiley
• Robert G Williams, DDS
• Paul Dana Willms, FNP-C

• Occupational Therapist in Port Jefferson, NY
• Providers in Port Jefferson, 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 Oct 4, 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.