Individual provider Active NPI

Brooke Ashley Romeo

  • Occupational Therapy Assistant
  • Oswego, NY
National Provider Identifier
1164057683
Registry record updated Mar 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
104628-01 Issued in NY
Practice address
159 W 1St St
Oswego, NY 13126-2045
Phone
(315) 342-9575
Fax
(315) 342-7664
NPI assigned
Mar 4, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2020

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 104628-01 NY Primary

Addresses

Primary practice location

159 W 1St St
Oswego, NY 13126-2045

Mailing address

143 N Auringer Rd
Constantia, NY 13044-2739
Phone (315) 247-4555

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
104628-01NYMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1583280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583280000000",
    "number": "1164057683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "143 N AURINGER RD",
            "city": "CONSTANTIA",
            "state": "NY",
            "postal_code": "130442739",
            "telephone_number": "315-247-4555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 W 1ST ST",
            "city": "OSWEGO",
            "state": "NY",
            "postal_code": "131262045",
            "telephone_number": "315-342-9575",
            "fax_number": "315-342-7664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMEO",
        "first_name": "BROOKE",
        "middle_name": "ASHLEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-04",
        "last_updated": "2020-03-04",
        "certification_date": "2020-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NY",
            "license": "104628-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oswego, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2020; 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.