NPIMap

Organization Active NPI

Homestay P.C.

  • Gerontology Occupational Therapist
  • Garfield, NJ
National Provider Identifier
1225525371
Registry record updated Apr 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Occupational TherapistTaxonomy code 225XG0600X
License
46TR00724200 Issued in NJ
Legal business name
HOMESTAY P.C.
Practice address
103 Somerset St
Garfield, NJ 07026-1827
Phone
(646) 645-0582
NPI assigned
Apr 14, 2018
Last updated
Apr 14, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Simon Levin, OTR/LNPI 1669838744
Title
President
Phone
(646) 645-0582

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Occupational Therapist 225XG0600X 46TR00724200 NJ Primary

Addresses

Primary practice location

103 Somerset St
Garfield, NJ 07026-1827

Mailing address

103 Somerset St
Garfield, NJ 07026-1827
Phone (646) 645-0582

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180716002712 NJ Part B Supplier - Physical/Occupational Therapy Group in Private Practice 8022365592 Receives reassigned benefits from 12 practitioners
Practice locations: Garfield, NJ

National Provider Directory

National Provider Directory

Locations

103 Somerset St
Garfield, NJ 07026
Phone (646) 645-0582

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1523664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523664000000",
    "number": "1225525371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 SOMERSET ST",
            "city": "GARFIELD",
            "state": "NJ",
            "postal_code": "070261827",
            "telephone_number": "646-645-0582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 SOMERSET ST",
            "city": "GARFIELD",
            "state": "NJ",
            "postal_code": "070261827",
            "telephone_number": "646-645-0582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOMESTAY P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-14",
        "last_updated": "2018-04-14",
        "status": "A",
        "authorized_official_last_name": "LEVIN",
        "authorized_official_first_name": "SIMON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "646-645-0582",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "225XG0600X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Gerontology",
            "state": "NJ",
            "license": "46TR00724200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garfield, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2018; 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.