Individual provider Active NPI

Clyde Matthew Ranada Labial

  • Occupational Therapist
  • New York, NY
National Provider Identifier
1245928936
Registry record updated May 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
027637-01 Issued in NY
Practice address
1 Nagle Ave
New York, NY 10040-1405
Phone
(212) 928-7800
Fax
(212) 928-7900
NPI assigned
May 1, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2023

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 027637-01 NY Primary

Addresses

Primary practice location

1 Nagle Ave
New York, NY 10040-1405

Mailing address

16414 Goethals Ave
Jamaica, NY 11432-1224
Phone (929) 412-9527

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230524001099 NY Practitioner - Physical Therapist in Private Practice 8426414087 Reassigns benefits to 1 organization
I20240415002079 NY Practitioner - Occupational Therapist in Private Practice 8426414087 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1870 Grand Concourse
FL 3
Bronx, NY 10457-5402
Phone (929) 412-9527

Merit-based Incentive Payment System (MIPS)

Final score
84.73 of 100Reported as group
Quality
75.36
Improvement activities
40
Cost
71.28

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
027637-01NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Theradynamics Rehab. PT, OT & SLP, PLLC Occupational Therapist CurrentSince May 1, 2023 Accepting new patients
Momentum Physical & Occupational Therapy, PLLC Occupational Therapist CurrentSince May 25, 2024 Accepting new patients

Locations

1870 Grand Concourse
Fl 2
Bronx, NY 10457
Phone (347) 431-3824

1870 Grand Concourse
Fl 3
Bronx, NY 10457
Phone (347) 205-8280

280 W 231st St
Bronx, NY 10463
Phone (718) 548-1212

18716 Hillside Ave
Jamaica, NY 11432
Phone (718) 206-1288

1 Nagle Ave
New York, NY 10040
Phone (212) 928-7800

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": "1682899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682899200000",
    "number": "1245928936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16414 GOETHALS AVE",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114321224",
            "telephone_number": "929-412-9527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 NAGLE AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100401405",
            "telephone_number": "212-928-7800",
            "fax_number": "212-928-7900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LABIAL",
        "first_name": "CLYDE MATTHEW",
        "middle_name": "RANADA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-01",
        "last_updated": "2023-05-01",
        "certification_date": "2023-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "027637-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2023; 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.