Individual provider Active NPI

Anthony Robert Kwalwasser, OTR/L

  • Pediatric Occupational Therapist
  • Mount Kisco, NY
National Provider Identifier
1235771635
Registry record updated Oct 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
024073 Issued in NY
Practice address
101 S Bedford Rd Ste 404
Mount Kisco, NY 10549-3455
Phone
(914) 421-8270
NPI assigned
Oct 17, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 5277 CT
Occupational Therapist 225X00000X 024073 NY
Pediatric Occupational Therapist 225XP0200X 024073 NY Primary

Addresses

Primary practice location

101 S Bedford Rd Ste 404
Mount Kisco, NY 10549-3455

Mailing address

6 Conley CT
Ridgefield, CT 06877-3202
Phone (203) 470-4771

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5277CTMDOccupational Therapist
024073NYMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1571270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571270400000",
    "number": "1235771635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 CONLEY CT",
            "city": "RIDGEFIELD",
            "state": "CT",
            "postal_code": "068773202",
            "telephone_number": "203-470-4771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 S BEDFORD RD STE 404",
            "city": "MOUNT KISCO",
            "state": "NY",
            "postal_code": "105493455",
            "telephone_number": "914-421-8270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWALWASSER",
        "first_name": "ANTHONY",
        "middle_name": "ROBERT",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-17",
        "last_updated": "2019-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CT",
            "license": "5277",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "024073",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NY",
            "license": "024073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Kisco, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.