Individual provider Active NPI

Michael Sebastian, OT

  • Occupational Therapist
  • Clifton Park, NY
National Provider Identifier
1225066137
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
007094 Issued in NY
Practice address
648 Plank Rd
Clifton Park, NY 12065-2062
Phone
(518) 268-4800
Fax
(518) 268-4888
NPI assigned
Jun 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 007094 NY Primary

Addresses

Primary practice location

648 Plank Rd
Clifton Park, NY 12065-2062

Mailing address

648 Plank Rd
Clifton Park, NY 12065-2062
Phone (518) 268-4800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190125002381 NY Practitioner - Occupational Therapist in Private Practice 6002153210 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
007094NYMDOccupational Therapy Assistant

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": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225066137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "648 PLANK RD",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "120652062",
            "telephone_number": "518-268-4800",
            "fax_number": "518-268-4888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "648 PLANK RD",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "120652062",
            "telephone_number": "518-268-4800",
            "fax_number": "518-268-4888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEBASTIAN",
        "first_name": "MICHAEL",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "007094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.