Keith Koppenhoefer, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

019258-1 Issued in NY

Practice address

115 Lincoln Dr
Oakdale, NY 11769-2133

Phone

(631) 327-7339

NPI assigned

May 4, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Touro Un Col of Osteopathic Medicine, New York, 2014

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Medcare Therapy Services:Physical, Occupational & Massage Therapy,PLLC

  • Physical Therapist
  • Holbrook, NY
  • NPI 1326355132

  Occupational Therapist

  Medicare reassignment NPD

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

{
    "created_epoch": "1556928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556928000000",
    "number": "1154986222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 LINCOLN DR",
            "city": "OAKDALE",
            "state": "NY",
            "postal_code": "117692133",
            "telephone_number": "631-327-7339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 LINCOLN DR",
            "city": "OAKDALE",
            "state": "NY",
            "postal_code": "117692133",
            "telephone_number": "631-327-7339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOPPENHOEFER",
        "first_name": "KEITH",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-04",
        "last_updated": "2019-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "019258-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Learn. Eat. Talk. Smile. Speech Therapy (LETS Speech Therapy)

• Occupational Therapist in Oakdale, NY
• Providers in Oakdale, NY by specialty
• Occupational Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2019; 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.