Individual provider Active NPI

Christine Mary Nugent, OTR

  • Occupational Therapist
  • Kings Park, NY
National Provider Identifier
1285901330
Registry record updated Nov 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
003652 Issued in NY
Practice address
51 Old Dock Rd
Kings Park, NY 11754-2613
Phone
(631) 662-6107
NPI assigned
Nov 17, 2011
Last updated
Nov 17, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2011

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 003652 NY Primary

Addresses

Primary practice location

51 Old Dock Rd
Kings Park, NY 11754-2613

Mailing address

51 Old Dock Rd
Kings Park, NY 11754-2613
Phone (631) 662-6107

Other identifiers 1

IdentifierTypeStateIssuer
003652OtherNYOT LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170109002447 NY Practitioner - Occupational Therapist in Private Practice 7315228228 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Epic Medical Services PCGroup PAC ID 8628365582, 27 clinicians

Practice addresses (Care Compare)

1500 Hempstead Tpke
East Meadow, NY 11554-1551
Phone (516) 739-7733

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Epic Medical Services PC CurrentSince Oct 17, 2016 Accepting new patients

Locations

1500 Hempstead Tpke
East Meadow, NY 11554
Phone 51673977331420

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1321488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321488000000",
    "number": "1285901330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 OLD DOCK RD",
            "city": "KINGS PARK",
            "state": "NY",
            "postal_code": "117542613",
            "telephone_number": "631-662-6107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 OLD DOCK RD",
            "city": "KINGS PARK",
            "state": "NY",
            "postal_code": "117542613",
            "telephone_number": "631-662-6107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUGENT",
        "first_name": "CHRISTINE",
        "middle_name": "MARY",
        "name_prefix": "Mrs.",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-11-17",
        "last_updated": "2011-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "003652",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OT LICENSE",
            "identifier": "003652",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kings Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2011; 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.