Kaitlyn Sullivan

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

018458 Issued in NY

Practice address

1363 Veterans Memorial Hwy Ste 8
Hauppauge, NY 11788-3046

Phone

(631) 366-3876

NPI assigned

Jan 8, 2014

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

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Sports Physical Therapy Occupational Therapy and Rehabilitation Servic

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

  Occupational Therapist

  Medicare reassignment NPD
• Sports Physical Therapy Occupational Therapy and Rehabilitation Servic

  • Occupational Therapist
  • White Plains, NY
  • NPI 1629825591
  NPD

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

{
    "created_epoch": "1389139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676332800000",
    "number": "1124440276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 CORDELL PL",
            "city": "EAST NORTHPORT",
            "state": "NY",
            "postal_code": "117312622",
            "telephone_number": "631-356-5561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1363 VETERANS MEMORIAL HWY STE 8",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "117883046",
            "telephone_number": "631-366-3876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "KAITLYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-08",
        "last_updated": "2023-02-14",
        "certification_date": "2023-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "018458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapist in Hauppauge, NY
• Providers in Hauppauge, 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 Feb 14, 2023; 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.