Active NPI
Kristen Rose
- Occupational Therapy Assistant
- East Moriches, NY
National Provider Identifier
1144891896
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 010800-1
- Practice address
- 130 Montauk Hwy Unit F
East Moriches, NY 11940-1153 - Phone
- (631) 878-0795
- NPI assigned
- Jul 4, 2021
- Last updated
- Jul 4, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 010800-1 | NY | Primary |
Addresses
Primary practice location
130 Montauk Hwy Unit F
East Moriches, NY 11940-1153
Mailing address
43 Seminole St
Selden, NY 11784-2642
Phone (631) 926-9559
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
| License | State | Type | Specialty |
|---|---|---|---|
| 010800-1 | NY | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1625356800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1625356800000",
"number": "1144891896",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "43 SEMINOLE ST",
"city": "SELDEN",
"state": "NY",
"postal_code": "117842642",
"telephone_number": "631-926-9559"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "130 MONTAUK HWY UNIT F",
"city": "EAST MORICHES",
"state": "NY",
"postal_code": "119401153",
"telephone_number": "631-878-0795"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSE",
"first_name": "KRISTEN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-07-04",
"last_updated": "2021-07-04",
"certification_date": "2021-07-04",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Occupational Therapy Assistant",
"state": "NY",
"license": "010800-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in East Moriches, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.