Individual provider Active NPI

Shayena Donaldson-Fortune, MSOT, OTR/L

  • Occupational Therapist
  • Valley Stream, NY
National Provider Identifier
1154846871
Registry record updated Sep 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
013641 Issued in NY
Practice address
100 Lotus Oval N
Valley Stream, NY 11581
Phone
(917) 569-5129
NPI assigned
Aug 3, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 013641 NY Primary

Addresses

Primary practice location

100 Lotus Oval N
Valley Stream, NY 11581

Mailing address

PO Box 445
Hewlett, NY 11557-0445
Phone (917) 569-5129

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170907000773 NY Practitioner - Occupational Therapist in Private Practice 5496028813 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

800 E Gate Blvd
Garden City, NY 11530-2105
Phone (516) 745-8070

Merit-based Incentive Payment System (MIPS)

Final score
77.35 of 100Reported as group
Quality
73.31
Improvement activities
40
Cost
73.42

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
013641NYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Patriot Family Medical Associates PLLC CurrentSince Oct 26, 2023 Accepting new patients
Visiting PT OT Services PLLC Occupational Therapist CurrentSince Oct 26, 2023 Accepting new patients
Metro Physical Occupational Speech Massage Therapy & Acupuncture PLLC Occupational Therapist CurrentSince Nov 7, 2024 Accepting new patients
Core Therapy Services PT OT PLLC Occupational Therapist CurrentSince May 1, 2022 Accepting new patients

Locations

2003 Coney Island Ave
Brooklyn, NY 11223
Phone (347) 394-1600

800 E Gate Blvd
Garden City, NY 11530

50 Glen Cove Rd
Greenvale, NY 11548
Phone (516) 200-3545

11701 84th Ave
Richmond Hill, NY 11418
Phone (718) 441-0300

85 Roosevelt Ave
Valley Stream, NY 11581
Phone (516) 791-9500

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1501718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631059200000",
    "number": "1154846871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 445",
            "city": "HEWLETT",
            "state": "NY",
            "postal_code": "115570445",
            "telephone_number": "917-569-5129",
            "fax_number": "516-792-6803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 LOTUS OVAL N",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "11581",
            "telephone_number": "917-569-5129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONALDSON-FORTUNE",
        "first_name": "SHAYENA",
        "credential": "MSOT, OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-03",
        "last_updated": "2021-09-08",
        "certification_date": "2021-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "013641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley Stream, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.