Individual provider Active NPI

Moryam Ladotun, OTR/L

  • Occupational Therapist
  • Brooklyn, NY
National Provider Identifier
1295901098
Registry record updated Apr 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
017172 Issued in NY
Practice address
1589 E 95TH St
Brooklyn, NY 11236-5413
Phone
(718) 763-2777
NPI assigned
May 1, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2022

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 017172 NY Primary

Addresses

Primary practice location

1589 E 95TH St
Brooklyn, NY 11236-5413

Mailing address

1589 E 95TH St
Brooklyn, NY 11236-5413
Phone (718) 763-2777

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120315000009 NY Practitioner - Occupational Therapist in Private Practice 3375702186 Reassigns benefits to 2 organizations
Practice locations: Woodside, NY; Rego Park, NY; Laurelton, NY; Brooklyn, NY; Astoria, NY; Bronx, NY

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Neighborhood Medical PCGroup PAC ID 0648673665, 3 clinicians

Practice addresses (Care Compare)

1343 Webster Ave
Bronx, NY 10456-1805
Phone (917) 471-9217

2555 Nostrand Ave
Brooklyn, NY 11210-4730
Phone 71895188002102

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Neighborhood Medical PC CurrentSince Jun 1, 2021 Accepting new patients
Ahava Medical and Rehabilitation Center, LLC CurrentSince Feb 1, 2012 Accepting new patients
Ahava Medical and Rehabilitation Center LLC Past Accepting new patients
Elnunu Medical PC PastSince Oct 20, 2022 Accepting new patients
Occupational Therapy Group, LLP Occupational Therapist Past Accepting new patients

Locations

1343 Webster Ave
Bronx, NY 10456
Phone (917) 453-8417

2555 Nostrand Ave
#1
Brooklyn, NY 11210

16 Sumner Pl
Brooklyn, NY 11206
Phone (718) 336-9500

2555 Nostrand Ave
Brooklyn, NY 11210
Phone 7189518800108

Networks

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

Organizations & group practices 5

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": "1209600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648771200000",
    "number": "1295901098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1589 E 95TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112365413",
            "telephone_number": "718-763-2777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1589 E 95TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112365413",
            "telephone_number": "718-763-2777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LADOTUN",
        "first_name": "MORYAM",
        "name_prefix": "Ms.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-01",
        "last_updated": "2022-04-01",
        "certification_date": "2022-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "017172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2022; 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.