Individual provider Active NPI

Ilysse Siers, COTA

  • Occupational Therapy Assistant
  • Flushing, NY
National Provider Identifier
1154656650
Registry record updated Oct 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
001595-1 Issued in NY
Practice address
15611 Aguilar Ave
Apt. 3P
Flushing, NY 11367-2732
Phone
(917) 741-6096
NPI assigned
Oct 16, 2009
Last updated
Oct 16, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2009

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 001595-1 NY Primary

Addresses

Primary practice location

15611 Aguilar Ave
Apt. 3P
Flushing, NY 11367-2732

Mailing address

15611 Aguilar Ave
Apt. 3P
Flushing, NY 11367-2732
Phone (917) 741-6096

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
001595-1NYMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1255651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255651200000",
    "number": "1154656650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15611 AGUILAR AVE",
            "address_2": "APT. 3P",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113672732",
            "telephone_number": "917-741-6096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15611 AGUILAR AVE",
            "address_2": "APT. 3P",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113672732",
            "telephone_number": "917-741-6096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIERS",
        "first_name": "ILYSSE",
        "name_prefix": "Mrs.",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-10-16",
        "last_updated": "2009-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NY",
            "license": "001595-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2009; 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.