Active NPI
Avital Sobol
- Occupational Therapist
- Staten Island, NY
National Provider Identifier
1316572381
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 024491
- Practice address
- 3391 Richmond Ave
Staten Island, NY 10312-2025 - Phone
- (718) 608-9170
- NPI assigned
- Mar 10, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 024491 | NY | Primary |
Addresses
Primary practice location
3391 Richmond Ave
Staten Island, NY 10312-2025
Mailing address
3391 Richmond Ave
Staten Island, NY 10312-2025
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY, NJ
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Occupational Therapist in Private Practice
- Education
- Other, 2019
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
153 Richard CT
Pomona, NY 10970-2307
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 024491 | NY | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Medical & Dental Care Inc | Current | Accepting new patients | |
| Link Home Therapy Services of Ny-PT OT SLP PLLC | Current | Accepting new patients |
Locations
180 Sylvan Ave
Ste 4
Englewood Cliffs, NJ 07632
Phone (347) 841-8943
40 Robert Pitt Dr
Monsey, NY 10952
Phone (845) 352-6800
108 S Franklin Ave
Ste 10
Valley Stream, NY 11580
Organizations & group practices 3
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.
-
- Federally Qualified Health Center (FQHC)
- Monsey, NY
- NPI 1972681484
-
- Physical Therapy Clinic/Center
- Valley Stream, NY
- NPI 1942782966
-
- Physical Therapist
- Shrewsbury, NJ
- NPI 1609406438
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1583798400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583798400000",
"number": "1316572381",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3391 RICHMOND AVE",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103122025"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3391 RICHMOND AVE",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103122025",
"telephone_number": "718-608-9170"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOBOL",
"first_name": "AVITAL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-03-10",
"last_updated": "2020-03-10",
"certification_date": "2020-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "024491",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Staten Island, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2020; 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.