Active NPI
Melba Ocampo Suarez-Iavarone, PT
- Physical Therapist
- New York, NY
National Provider Identifier
1356553796
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 021408-1
- Practice address
- 24 5TH Ave Apt 1112
New York, NY 10011-8820 - Phone
- (917) 685-9334
- Fax
- (212) 228-2052
- NPI assigned
- May 6, 2007
- Last updated
- Jul 8, 2007
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 021408-1 | NY | Primary |
Addresses
Primary practice location
24 5TH Ave Apt 1112
New York, NY 10011-8820
Mailing address
3935 51St St Apt 4F
Woodside, NY 11377-3168
Phone (718) 440-7709
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 021408-1 | NY | MD | Physical Therapist |
| 021408 | NY | MD | Surgical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Outreach Physical and Occupational Therapy & Speech Rehabilitation, PLLC | Physical Therapist | Current | Accepting new patients |
| Outreach Physical Therapy PC | Physical Therapist | Past | Accepting new patients |
Locations
3 Grace Ave
Ste 119
Great Neck, NY 11021
Phone (212) 842-0080
147 W 35th St
Ste 407
New York, NY 10001
Phone (212) 842-0080
Organizations & group practices 2
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.
-
- Physical Therapist
- Great Neck, NY
- NPI 1841526399
-
- Physical Therapist
- New York, NY
- NPI 1437222890
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178409600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1356553796",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3935 51ST ST APT 4F",
"city": "WOODSIDE",
"state": "NY",
"postal_code": "113773168",
"telephone_number": "718-440-7709",
"fax_number": "718-606-9733"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24 5TH AVE APT 1112",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100118820",
"telephone_number": "917-685-9334",
"fax_number": "212-228-2052"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUAREZ-IAVARONE",
"first_name": "MELBA",
"middle_name": "OCAMPO",
"name_prefix": "Mrs.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "021408-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in New York, 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.