Individual provider Active NPI

Kelly Crowley

  • Occupational Therapist
  • Riverhead, NY
National Provider Identifier
1174073720
Registry record updated Oct 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
020572-1 Issued in NY
Practice address
1300 Roanoke Ave
Riverhead, NY 11901-2031
Phone
(631) 548-6000
NPI assigned
Oct 7, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 7, 2016

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 020572-1 NY Primary

Addresses

Primary practice location

1300 Roanoke Ave
Riverhead, NY 11901-2031

Mailing address

23 Foster Xing
East Quogue, NY 11942-4332
Phone (631) 807-0338

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240502000040 NY Practitioner - Occupational Therapist in Private Practice 6103266556 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

5958 Ny
25A
Wading River, NY 11792-0521
Phone (631) 929-8200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
020572NYMDPsychologist
020572-1NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Horizon Occupational Therapy Services, P.C. Occupational Therapist CurrentSince Apr 1, 2025 Accepting new patients
Metro Physical Occupational Speech Massage Therapy & Acupuncture PLLC Occupational Therapist CurrentSince Jul 15, 2024 Accepting new patients

Locations

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

5958 Route 25A
Wading River, NY 11792
Phone (631) 804-9410

Organizations & group practices 3

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": "1475798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475798400000",
    "number": "1174073720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 FOSTER XING",
            "city": "EAST QUOGUE",
            "state": "NY",
            "postal_code": "119424332",
            "telephone_number": "631-807-0338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 ROANOKE AVE",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119012031",
            "telephone_number": "631-548-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROWLEY",
        "first_name": "KELLY",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-07",
        "last_updated": "2016-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "020572-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverhead, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2016; 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.