Individual provider Active NPI

Loren Wilanski, OTR/L

  • Occupational Therapist
  • Brooklyn, NY
National Provider Identifier
1235474107
Registry record updated Dec 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
017765 Issued in NY
Practice address
2712 Mill Ave
Upstairs
Brooklyn, NY 11234-6422
Phone
(917) 439-7275
NPI assigned
Dec 4, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 4, 2012

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 017765 NY Primary

Addresses

Primary practice location

2712 Mill Ave
Upstairs
Brooklyn, NY 11234-6422

Mailing address

2712 Mill Ave
Upstairs
Brooklyn, NY 11234-6422
Phone (917) 439-7275

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170816003274 NY Practitioner - Occupational Therapist in Private Practice 2668744251 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
Quentin Medical PCGroup PAC ID 2062302649, 5 clinicians

Practice addresses (Care Compare)

280 Quentin Rd
Brooklyn, NY 11223-1628
Phone (718) 336-4499

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
017765NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Quentin Medical PC CurrentSince Jul 5, 2017 Accepting new patients
Quentin Medical, P.C Current Accepting new patients

Locations

280 Quentin Rd
Brooklyn, NY 11223
Phone (718) 336-4499

Organizations & group practices 2

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": "1354579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354579200000",
    "number": "1235474107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2712 MILL AVE",
            "address_2": "UPSTAIRS",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112346422",
            "telephone_number": "917-439-7275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2712 MILL AVE",
            "address_2": "UPSTAIRS",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112346422",
            "telephone_number": "917-439-7275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILANSKI",
        "first_name": "LOREN",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-12-04",
        "last_updated": "2012-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "017765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2012; 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.