Individual provider Active NPI

Samuel Rafol Rabino Jr., OT

  • Occupational Therapist
  • Rockaway Park, NY
National Provider Identifier
1275779019
Registry record updated Dec 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
014632 Issued in NY
Practice address
11432 Rockaway Beach Blvd
Rockaway Park, NY 11694-2302
Phone
(718) 318-0090
NPI assigned
Dec 29, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 29, 2008

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 014632 NY Primary

Addresses

Primary practice location

11432 Rockaway Beach Blvd
Rockaway Park, NY 11694-2302

Mailing address

11432 Rockaway Beach Blvd
Rockaway Park, NY 11694-2302
Phone (718) 318-0090

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090314000023 NY Practitioner - Occupational Therapist in Private Practice 4183781396 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8523 Broadway
Unit 1C D
Elmhurst, NY 11373-5866
Phone (718) 326-3601

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
014632NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Dragon Occupational Therapy P.C. Occupational Therapist CurrentSince Mar 1, 2014 Accepting new patients
Antioquia Chiropractic P.C CurrentSince Mar 20, 2018 Accepting new patients
Health Pro OT, PC Occupational Therapist Past Accepting new patients
Oasis Nurse Practitioner in Adult Health PC Past Accepting new patients

Locations

13616 35th Ave
Ste 1D
Flushing, NY 11354
Phone (718) 939-8600

7517 Metropolitan Ave
Middle Vlg, NY 11379
Phone (718) 326-0400

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678

Organizations & group practices 4

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": "1230508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1230508800000",
    "number": "1275779019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11432 ROCKAWAY BEACH BLVD",
            "city": "ROCKAWAY PARK",
            "state": "NY",
            "postal_code": "116942302",
            "telephone_number": "718-318-0090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11432 ROCKAWAY BEACH BLVD",
            "city": "ROCKAWAY PARK",
            "state": "NY",
            "postal_code": "116942302",
            "telephone_number": "718-318-0090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RABINO",
        "first_name": "SAMUEL",
        "middle_name": "RAFOL",
        "name_suffix": "Jr.",
        "credential": "OT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-12-29",
        "last_updated": "2008-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "014632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockaway Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2008; 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.