Individual provider Active NPI

Maddalena Passalacqua

  • Occupational Therapist
  • Bayville, NY
National Provider Identifier
1396536785
Registry record updated May 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
018136 Issued in NY
Practice address
3 Whitney Rd
Bayville, NY 11709-2406
Phone
(516) 680-9776
NPI assigned
May 14, 2025
Sex
Unspecified or another gender identity
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2025

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 018136 NY Primary

Addresses

Primary practice location

3 Whitney Rd
Bayville, NY 11709-2406

Mailing address

3 Whitney Rd
Bayville, NY 11709-2406
Phone (516) 680-9776

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250520001316 NY Practitioner - Occupational Therapist in Private Practice 8628596962 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
New York College of Osteo Medicine of New York Institute of Technology, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Visiting PT OT Services PLLCGroup PAC ID 1153721899, 22 clinicians

Practice addresses (Care Compare)

85 Roosevelt Ave
Valley Stream, NY 11581-1133
Phone (646) 886-8687

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Patriot Family Medical Associates PLLC CurrentSince May 14, 2025 Accepting new patients
Visiting PT OT Services PLLC Occupational Therapist CurrentSince May 14, 2025 Accepting new patients

Locations

85 Roosevelt Ave
Valley Stream, NY 11581
Phone (516) 791-9500

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1747180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747180800000",
    "number": "1396536785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 WHITNEY RD",
            "city": "BAYVILLE",
            "state": "NY",
            "postal_code": "117092406",
            "telephone_number": "516-680-9776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 WHITNEY RD",
            "city": "BAYVILLE",
            "state": "NY",
            "postal_code": "117092406",
            "telephone_number": "516-680-9776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASSALACQUA",
        "first_name": "MADDALENA",
        "sole_proprietor": "YES",
        "sex": "X",
        "enumeration_date": "2025-05-14",
        "last_updated": "2025-05-14",
        "certification_date": "2025-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "018136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.