Active NPI
Elliot Engelhardt, MS OTR/L
- Occupational Therapist
- Bronx, NY
National Provider Identifier
1205072964
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 015085
- Practice address
- 866 E Tremont Ave
Bronx, NY 10460-4201 - Phone
- (718) 589-2200
- NPI assigned
- Dec 31, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 015085 | NY | Primary |
Addresses
Primary practice location
866 E Tremont Ave
Bronx, NY 10460-4201
Mailing address
866 E Tremont Ave
Bronx, NY 10460-4201
Phone (718) 589-2200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03195544 | Medicaid | NY |
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)
- Enrolled
- Credentials
- Master of Science
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| One to One OT PT SLP PLLC | Occupational Therapist | Past | Accepting new patients |
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": "1230681600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1340150400000",
"number": "1205072964",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "866 E TREMONT AVE",
"city": "BRONX",
"state": "NY",
"postal_code": "104604201",
"telephone_number": "718-589-2200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "866 E TREMONT AVE",
"city": "BRONX",
"state": "NY",
"postal_code": "104604201",
"telephone_number": "718-589-2200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ENGELHARDT",
"first_name": "ELLIOT",
"credential": "MS OTR/L",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-12-31",
"last_updated": "2012-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "015085",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "03195544",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.