Active NPI
Crystal Mary Santo, COTA
- Occupational Therapy Assistant
- Prospect, CT
National Provider Identifier
1336627256
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 001829
- Practice address
- 48 Beach Dr
Prospect, CT 06712-1603 - Phone
- (203) 868-5206
- NPI assigned
- Aug 2, 2018
- 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 Therapy Assistant | 224Z00000X | 001829 | CT | Primary |
Addresses
Primary practice location
48 Beach Dr
Prospect, CT 06712-1603
Mailing address
48 Beach Dr
Prospect, CT 06712-1603
Phone (203) 868-5206
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001829 | Medicaid | CT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1533168000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1533168000000",
"number": "1336627256",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "48 BEACH DR",
"city": "PROSPECT",
"state": "CT",
"postal_code": "067121603",
"telephone_number": "203-868-5206"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "48 BEACH DR",
"city": "PROSPECT",
"state": "CT",
"postal_code": "067121603",
"telephone_number": "203-868-5206"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANTO",
"first_name": "CRYSTAL",
"middle_name": "MARY",
"credential": "COTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-08-02",
"last_updated": "2018-08-02",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "CT",
"license": "001829",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001829",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Prospect, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.