Individual provider Active NPI

Igor Koval

  • Occupational Therapist
  • Brooklyn, NY
National Provider Identifier
1326265703
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
006839
Practice address
1219 Quentin Rd
Brooklyn, NY 11229-1054
Phone
(718) 339-6425
NPI assigned
Apr 19, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 006839 Primary

Addresses

Primary practice location

1219 Quentin Rd
Brooklyn, NY 11229-1054

Mailing address

227 Holland Rd
Holmdel, NJ 07733-1216
Phone (917) 656-6757

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101201000777 NJ Practitioner - Occupational Therapist in Private Practice 1951402080 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Therapeutic Rehab LLC Occupational Therapist CurrentSince Jan 29, 2014 Accepting new patients
Kovtherapro Inc Occupational Therapist Current Accepting new patients
Koval Inc Occupational Therapist Past Accepting new patients
Therapeutic Rehab LLC Occupational Therapist Past Accepting new patients

Locations

18 Worlds Fair Dr
Somerset, NJ 08873
Phone (732) 271-8010

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": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1326265703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "227 HOLLAND RD",
            "city": "HOLMDEL",
            "state": "NJ",
            "postal_code": "077331216",
            "telephone_number": "917-656-6757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1219 QUENTIN RD",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112291054",
            "telephone_number": "718-339-6425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOVAL",
        "first_name": "IGOR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": "006839",
            "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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.