Individual provider Active NPI

Alexandr Zatulovskiy, OT

  • Occupational Therapist
  • Brooklyn, NY
National Provider Identifier
1356809610
Registry record updated Mar 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
023388 Issued in NY
Practice address
3740 Lyme Ave
Brooklyn, NY 11224-1322
Phone
(917) 378-0492
NPI assigned
Mar 6, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 6, 2019

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 023388 NY Primary

Addresses

Primary practice location

3740 Lyme Ave
Brooklyn, NY 11224-1322

Mailing address

3740 Lyme Ave
Brooklyn, NY 11224-1322
Phone (917) 378-0492

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191025000276 NY Practitioner - Occupational Therapist in Private Practice 6709118672 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
New York Physical and Occupational Therapy Services, PLLC Occupational Therapist CurrentSince Oct 23, 2019 Accepting new patients
Assist Physical Therapy, PLLC CurrentSince Jan 13, 2020 Accepting new patients
At Your Doorstep OT PLLC Occupational Therapist CurrentSince Oct 11, 2024 Accepting new patients

Locations

2579 Ocean Ave
Fl 3
Brooklyn, NY 11229
Phone (646) 780-0925

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1551830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551830400000",
    "number": "1356809610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3740 LYME AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112241322",
            "telephone_number": "917-378-0492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3740 LYME AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112241322",
            "telephone_number": "917-378-0492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZATULOVSKIY",
        "first_name": "ALEXANDR",
        "name_prefix": "Mr.",
        "credential": "OT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-06",
        "last_updated": "2019-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "023388",
            "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 Mar 6, 2019; 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.