Individual provider Active NPI

Heather Passaretti, OTR/L

  • Pediatric Occupational Therapist
  • Latham, NY
National Provider Identifier
1417322652
Registry record updated Sep 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
020249 Issued in NY
Practice address
623 New Loudon Rd
Latham, NY 12110-4031
Phone
(518) 330-3122
NPI assigned
Dec 13, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 020249 NY Primary

Addresses

Primary practice location

623 New Loudon Rd
Latham, NY 12110-4031

Mailing address

623 New Loudon Rd
Latham, NY 12110-4031
Phone (518) 330-3122

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
020249NYMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Blooming Tree, LLC Current Accepting new patients

Organizations & group practices 1

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": "1449964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568160000000",
    "number": "1417322652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "623 NEW LOUDON RD",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121104031",
            "telephone_number": "518-330-3122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "623 NEW LOUDON RD",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121104031",
            "telephone_number": "518-330-3122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASSARETTI",
        "first_name": "HEATHER",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-13",
        "last_updated": "2019-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NY",
            "license": "020249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Latham, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.