Individual provider Active NPI

Ethel Marie Delicana

  • Occupational Therapist
  • New York, NY
National Provider Identifier
1194434100
Registry record updated Mar 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
024543 Issued in NY
Practice address
3648 Broadway, New York, Ny 10031
New York, NY 10031-1003
Phone
(929) 593-7462
NPI assigned
Nov 17, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2025

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 024543 NY Primary

Addresses

Primary practice location

3648 Broadway, New York, Ny 10031
New York, NY 10031-1003

Mailing address

3648 Broadway, New York, Ny 10031
New York, NY 10031-2468
Phone (929) 593-7462

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230112001800 NY Practitioner - Occupational Therapist in Private Practice 0244600021 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Theradynamics Rehab PT, OT and SLP, PLLCGroup PAC ID 4082045802, 63 clinicians

Practice addresses (Care Compare)

3644 -48 Broadway
New York, NY 10031-2520
Phone (718) 514-6120

Merit-based Incentive Payment System (MIPS)

Final score
84.73 of 100Reported as group
Quality
75.36
Improvement activities
40
Cost
71.28

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Theradynamics Rehab. PT, OT & SLP, PLLC Occupational Therapist CurrentSince Dec 1, 2022 Accepting new patients

Locations

280 W 231st St
Bronx, NY 10463
Phone (718) 548-1212

18716 Hillside Ave
Jamaica, NY 11432
Phone (718) 206-1288

Organizations & group practices 1

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": "1668643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742428800000",
    "number": "1194434100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3648 BROADWAY, NEW YORK, NY 10031",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100312468",
            "telephone_number": "929-593-7462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3648 BROADWAY, NEW YORK, NY 10031",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100311003",
            "telephone_number": "929-593-7462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELICANA",
        "first_name": "ETHEL",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-17",
        "last_updated": "2025-03-20",
        "certification_date": "2025-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "024543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2025; 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.