Individual provider Active NPI

David Kalandarov, COTA

  • Occupational Therapy Assistant
  • Forest Hills, NY
National Provider Identifier
1124667399
Registry record updated Jan 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
003836 Issued in NY
Practice address
10543 63Rd Ave
Forest Hills, NY 11375-1346
Phone
(718) 755-4444
NPI assigned
Jan 5, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 5, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 003836 NY Primary

Addresses

Primary practice location

10543 63Rd Ave
Forest Hills, NY 11375-1346

Mailing address

10543 63Rd Ave
Forest Hills, NY 11375-1346
Phone (718) 755-4444

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
003836NYMDEndocrinology, Diabetes & Metabolism Physician

NPI Registry JSON

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

{
    "created_epoch": "1578182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578182400000",
    "number": "1124667399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10543 63RD AVE",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113751346",
            "telephone_number": "718-755-4444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10543 63RD AVE",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113751346",
            "telephone_number": "718-755-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALANDAROV",
        "first_name": "DAVID",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-01-05",
        "last_updated": "2020-01-05",
        "certification_date": "2020-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NY",
            "license": "003836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.