Individual provider Active NPI

Alexa Lagrande, OTR/L

  • Occupational Therapist
  • Latham, NY
National Provider Identifier
1245903020
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
025959 Issued in NY
Practice address
711 Troy Schenectady Rd Ste 216
Latham, NY 12110-2461
Phone
(518) 786-1665
Fax
(518) 785-0056
NPI assigned
Jul 28, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2024

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 025959 NY Primary

Addresses

Primary practice location

711 Troy Schenectady Rd Ste 216
Latham, NY 12110-2461

Mailing address

711 Troy Schenectady Rd Ste 209
Latham, NY 12110-2481
Phone (518) 786-1667

Other identifiers 1

IdentifierTypeStateIssuer
07874702MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240509000781 NY Practitioner - Occupational Therapist in Private Practice 6103267083 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
025959NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Nicolla and Associates, PT & OT Services, PLLC CurrentSince Apr 29, 2024 Accepting new patients
Thomas Nicolla Consulting Services, PLLC CurrentSince Apr 29, 2024 Accepting new patients
Thomas Nicolla Consulting Services, PLLC PastSince Apr 28, 2024 Accepting new patients

Locations

1367 Washington Ave
Ste 100
Albany, NY 12206
Phone (518) 438-7926

711 Troy Schenectady Rd
Ste 209
Latham, NY 12110
Phone (518) 786-1667

711 Troy Schenectady Rd
Ste 216
Latham, NY 12110
Phone (518) 786-1665

Organizations & group practices 3

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": "1627430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1245903020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 TROY SCHENECTADY RD STE 209",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102481",
            "telephone_number": "518-786-1667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 TROY SCHENECTADY RD STE 216",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102461",
            "telephone_number": "518-786-1665",
            "fax_number": "518-785-0056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAGRANDE",
        "first_name": "ALEXA",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-28",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "025959",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07874702",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Latham, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2024; 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.