NPIMap

Organization Active NPI

Douglas O T Services P.C.

  • Occupational Therapist
  • Brooklyn, NY
National Provider Identifier
1154441129
Registry record updated Aug 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
005500 Issued in NY
Legal business name
DOUGLAS O T SERVICES P.C.
Practice address
4319 Church Ave
Brooklyn, NY 11203-3101
Phone
(718) 978-3188
Fax
(718) 221-5530
NPI assigned
Mar 31, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2013

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

Authorized official

Name
Mr. Bruce Douglas, OTR LICNPI 1023233558
Title
Executive Officer
Phone
(718) 978-3188

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225X00000X 005500 NY Primary

Addresses

Primary practice location

4319 Church Ave
Brooklyn, NY 11203-3101

Mailing address

609 Midwood St
Brooklyn, NY 11203-1103
Phone (718) 978-3188

Other names 1

  • Occupational Therapy Services Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090709000068 NY Part B Supplier - Clinic/Group Practice 6305739087 Receives reassigned benefits from 1 practitioner
Practice locations: Brooklyn, NY

National Provider Directory

National Provider Directory

Locations

221W 57TH St
New York, NY 10019
Phone (212) 399-3800

Practitioners & affiliated clinicians

Practitioners 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1175299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375315200000",
    "number": "1154441129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 MIDWOOD ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112031103",
            "telephone_number": "718-978-3188",
            "fax_number": "718-221-5530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4319 CHURCH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112033101",
            "telephone_number": "718-978-3188",
            "fax_number": "718-221-5530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOUGLAS O T SERVICES P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-31",
        "last_updated": "2013-08-01",
        "status": "A",
        "authorized_official_last_name": "DOUGLAS",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_title_or_position": "EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "718-978-3188",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "OTR LIC"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "005500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Occupational Therapy Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2013; 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.