Individual provider Active NPI

Richard Lance Whalley, OTD, OTR/L

  • Occupational Therapist
  • Ronkonkoma, NY
National Provider Identifier
1215556428
Registry record updated Apr 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
024666 Issued in NY
Practice address
622 Hawkins Ave
Ronkonkoma, NY 11779-2374
Phone
(631) 240-3579
NPI assigned
Apr 9, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2020

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 024666 NY Primary

Addresses

Primary practice location

622 Hawkins Ave
Ronkonkoma, NY 11779-2374

Mailing address

335 Central Islip Blvd
Ronkonkoma, NY 11779-3908
Phone (631) 981-6905

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200709001459 NY Practitioner - Occupational Therapist in Private Practice 2961825955 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Washington University School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lang Hand Therapy OT PLLCGroup PAC ID 9931531282, 3 clinicians

Practice addresses (Care Compare)

263 W End Ave
Apt 1C
New York, NY 10023-2613
Phone (212) 787-6585

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
024666-1NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Andrea E Nomberg Physician PC CurrentSince Oct 1, 2021 Accepting new patients
Lang Hand Therapy OT PLLC Occupational Therapist CurrentSince Jan 3, 2022 Accepting new patients
Bienetre Medical PC Occupational Therapist CurrentSince Dec 28, 2025 Accepting new patients
Sports Physical Therapy Occupational Therapy and Rehabilitation Servic Occupational Therapist CurrentSince Oct 1, 2021 Accepting new patients
Theralympic Speech Therapy PLLC CurrentSince Apr 15, 2020 Accepting new patients
Sports Physical Therapy Occupational Therapy and Rehabilitation Servic Occupational Therapist CurrentSince Oct 1, 2021 Accepting new patients

Locations

99 Hudson St
Fl 5
New York, NY 10013
Phone (646) 301-2578

263 W End Ave
Apt 1C
New York, NY 10023
Phone (212) 562-3625

9525 Queens Blvd
Ste 3D
Rego Park, NY 11374
Phone (718) 925-6212

622 Hawkins Ave
Ronkonkoma, NY 11779
Phone (631) 240-3579

Organizations & group practices 6

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": "1586390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586390400000",
    "number": "1215556428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "335 CENTRAL ISLIP BLVD",
            "city": "RONKONKOMA",
            "state": "NY",
            "postal_code": "117793908",
            "telephone_number": "631-981-6905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 HAWKINS AVE",
            "city": "RONKONKOMA",
            "state": "NY",
            "postal_code": "117792374",
            "telephone_number": "631-240-3579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHALLEY",
        "first_name": "RICHARD",
        "middle_name": "LANCE",
        "name_prefix": "Dr.",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-09",
        "last_updated": "2020-04-09",
        "certification_date": "2020-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "024666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ronkonkoma, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2020; 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.