Active NPI
Boris Basanilov, OT
- Occupational Therapist
- East Meadow, NY
National Provider Identifier
1356581003
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 63 014098
- Practice address
- 2201 Hempstead Turnpike
Nassau University Medical Center
East Meadow, NY 11554 - Phone
- (516) 572-6131
- Fax
- (516) 572-5793
- NPI assigned
- Feb 20, 2009
- Sex
- Male
- 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 | 63 014098 | NY | Primary |
Addresses
Primary practice location
2201 Hempstead Turnpike
Nassau University Medical Center
East Meadow, NY 11554
Mailing address
2201 Hempstead Turnpike
Nassau University Medical Center
East Meadow, NY 11554
Phone (516) 572-6131
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 63 014098 | Other | NY | LICENSE# |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 63 014098 | NY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1235088000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1235088000000",
"number": "1356581003",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2201 HEMPSTEAD TURNPIKE",
"address_2": "NASSAU UNIVERSITY MEDICAL CENTER",
"city": "EAST MEADOW",
"state": "NY",
"postal_code": "11554",
"telephone_number": "516-572-6131",
"fax_number": "516-572-5793"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2201 HEMPSTEAD TURNPIKE",
"address_2": "NASSAU UNIVERSITY MEDICAL CENTER",
"city": "EAST MEADOW",
"state": "NY",
"postal_code": "11554",
"telephone_number": "516-572-6131",
"fax_number": "516-572-5793"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BASANILOV",
"first_name": "BORIS",
"credential": "OT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-02-20",
"last_updated": "2009-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "63 014098",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE#",
"identifier": "63 014098",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in East Meadow, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.