NPIMap

Organization Active NPI

Stillwater Occupational Therapy & Social Work Group, PLLC

  • Occupational Therapist
  • Bay Shore, NY
National Provider Identifier
1154384287
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Legal business name
STILLWATER OCCUPATIONAL THERAPY & SOCIAL WORK GROUP, PLLC
Practice address
160 Howells Rd
Suite 2
Bay Shore, NY 11706-5320
Phone
(631) 647-7885
Fax
(631) 647-7893
NPI assigned
Apr 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Rae R Zysman
Title
President
Phone
(631) 647-7885

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X Primary

Addresses

Primary practice location

160 Howells Rd
Suite 2
Bay Shore, NY 11706-5320

Mailing address

160 Howells Rd
Suite 2
Bay Shore, NY 11706-5320
Phone (631) 647-7885

Other identifiers 1

IdentifierTypeStateIssuer
02640857MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050210000827 NY Part B Supplier - Clinic/Group Practice 8729030473 Receives reassigned benefits from 2 practitioners
Practice locations: Medford, NY; Saint James, NY; Lake Ronkonkoma, NY; Islip, NY; Holbrook, NY; Center Moriches, NY; Bay Shore, NY; Babylon, NY

National Provider Directory

National Provider Directory

Locations

160 Howells Rd
Ste 2
Bay Shore, NY 11706
Phone (631) 647-7885

36 Locust Ave
Islip, NY 11751
Phone (631) 665-3714

43 Walnut St
Oneonta, NY 13820
Phone (607) 432-6387

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1154384287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 HOWELLS RD",
            "address_2": "SUITE 2",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117065320",
            "telephone_number": "631-647-7885",
            "fax_number": "631-647-7893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 HOWELLS RD",
            "address_2": "SUITE 2",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117065320",
            "telephone_number": "631-647-7885",
            "fax_number": "631-647-7893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STILLWATER OCCUPATIONAL THERAPY & SOCIAL WORK GROUP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-10",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "ZYSMAN",
        "authorized_official_first_name": "RAE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-647-7885"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02640857",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Shore, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.