Kelly Ann Gannon, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

012458-1 Issued in NY

Practice address

501 S 14TH St
New Hyde Park, NY 11040-5576

Phone

(516) 328-3216

NPI assigned

Jul 14, 2009

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Islander Physical and Occupational Therapy Services, PLLC

  • Physical Therapy Clinic/Center
  • Bohemia, NY
  • NPI 1174959878
  Medicare reassignment

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

{
    "created_epoch": "1247529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247529600000",
    "number": "1396975140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 S 14TH ST",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110405576",
            "telephone_number": "516-328-3216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 S 14TH ST",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110405576",
            "telephone_number": "516-328-3216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANNON",
        "first_name": "KELLY",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-14",
        "last_updated": "2009-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "012458-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Renae Gambina, MS, OTR/L
• Amanda Gambino
• Gandhi Physician Assistant
• Shamala Gandhi, M.D.
• Stacey Sailesh Gandhi, M.D.
• Laurent Ganry
• Mitchell Gantman, OPTICIAN
• Eric Alan Gantwerker, MD, MMSC(MEDED)
• Kaitlyn Elizabeth Gantwerker, AUD
• Ziwei Gao

• Occupational Therapist in New Hyde Park, NY
• Providers in New Hyde Park, NY by specialty
• Occupational Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2009; 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.