Kaitlin Bristol, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

025474 Issued in NY

Practice address

58 Summit St
Staten Island, NY 10307-1832

Phone

(718) 984-0960

NPI assigned

Apr 5, 2021

Last updated

Aug 25, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1617580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787616000000",
    "number": "1255910451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2707 FOREST HAVEN BLVD",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088176336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58 SUMMIT ST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103071832",
            "telephone_number": "718-984-0960"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2707 Forest Haven Blvd",
            "address_purpose": "LOCATION",
            "city": "Edison",
            "state": "NJ",
            "postal_code": "088176336",
            "country_code": "US",
            "telephone_number": "516-462-4976",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRISTOL",
        "first_name": "KAITLIN",
        "name_prefix": "Ms.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-05",
        "last_updated": "2026-08-25",
        "certification_date": "2026-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "025474",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NJ",
            "license": "46TR00977300",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapist in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Occupational Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2026; 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.