Individual provider Active NPI

Katelynn Marie Sobrevega

  • Occupational Therapist
  • Brooklyn, NY
National Provider Identifier
1164849683
Registry record updated Dec 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
018714 Issued in NY
Practice address
672 Parkside Ave FL 4
Brooklyn, NY 11226-2298
Phone
(718) 513-2475
NPI assigned
Mar 21, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2023

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 018714 NY Primary

Addresses

Primary practice location

672 Parkside Ave FL 4
Brooklyn, NY 11226-2298

Mailing address

10 Hanover SQ Apt 21Z
New York, NY 10005-3574
Phone (516) 851-8884

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
018714NYMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1395360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702339200000",
    "number": "1164849683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 HANOVER SQ APT 21Z",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100053574",
            "telephone_number": "516-851-8884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "672 PARKSIDE AVE FL 4",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112262298",
            "telephone_number": "718-513-2475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOBREVEGA",
        "first_name": "KATELYNN",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-21",
        "last_updated": "2023-12-12",
        "certification_date": "2023-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "018714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Dec 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.