Individual provider Active NPI

Marie D Roy Licin

  • Occupational Therapist
  • Woodhaven, NY
National Provider Identifier
1275986507
Registry record updated Sep 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
020736 Issued in NY
Practice address
9406 Jamaica Ave
Woodhaven, NY 11421-2221
Phone
(631) 366-3876
NPI assigned
Jul 21, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2026

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 020736 NY Primary

Addresses

Primary practice location

9406 Jamaica Ave
Woodhaven, NY 11421-2221

Mailing address

15 Eddie Ave
North Babylon, NY 11703-2712
Phone (631) 949-8392

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240126003946 NY Practitioner - Occupational Therapist in Private Practice 5395198220 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anchor Health Homecare Services IncGroup PAC ID 2163802570, 96 clinicians

Practice addresses (Care Compare)

Brooklyn, NY 11206
Phone (718) 701-7300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Anchor Health Homecare Services Inc CurrentSince Dec 17, 2023 Accepting new patients
Brad & Ethan Health Solution Inc CurrentSince Jun 28, 2026 Accepting new patients

Locations

46 Cook St
Brooklyn, NY 11206
Phone (718) 701-7300

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": "1469059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788998400000",
    "number": "1275986507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 EDDIE AVE",
            "city": "NORTH BABYLON",
            "state": "NY",
            "postal_code": "117032712",
            "telephone_number": "631-949-8392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9406 JAMAICA AVE",
            "city": "WOODHAVEN",
            "state": "NY",
            "postal_code": "114212221",
            "telephone_number": "631-366-3876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROY LICIN",
        "first_name": "MARIE",
        "middle_name": "D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-21",
        "last_updated": "2026-09-10",
        "certification_date": "2026-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "020736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodhaven, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2026; 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.