Individual provider Active NPI

Fay Berger Itzkowitz, OTR/L

  • Occupational Therapist
  • Brooklyn, NY
National Provider Identifier
1447003629
Registry record updated Jul 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
029025 Issued in NY
Practice address
458 5TH Ave
Brooklyn, NY 11215-4643
Phone
(646) 847-1734
NPI assigned
Apr 8, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 029025 NY Primary
Physical Rehabilitation Occupational Therapist 225XP0019X 029025 NY

Addresses

Primary practice location

458 5TH Ave
Brooklyn, NY 11215-4643

Mailing address

1119 E 31St St
Brooklyn, NY 11210-4732

Other practice location 1

1119 E 31st St
Brooklyn, NY 11210-4732
Phone (917) 865-4867

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240523001004 NY Practitioner - Occupational Therapist in Private Practice 2769824648 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

458 5TH Ave
Brooklyn, NY 11215-4643
Phone (646) 847-1734

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
029025NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy-in-Motion Physical Therapy & Rehabilitation Services, PC CurrentSince May 16, 2024 Accepting new patients
Spear Physical and Occupational Therapy, LLC Occupational Therapist CurrentSince Jul 8, 2024 Accepting new patients
Direct Health LLC Occupational Therapist CurrentSince Jun 1, 2024 Accepting new patients

Locations

120 E 56th St
Rm 1010
New York, NY 10022
Phone (646) 790-7466

31 E 32nd St
Fl 4
New York, NY 10016
Phone (646) 973-5427

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": "1712534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720483200000",
    "number": "1447003629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1119 E 31ST ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112104732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "458 5TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112154643",
            "telephone_number": "646-847-1734"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1119 E 31st St",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112104732",
            "country_code": "US",
            "telephone_number": "917-865-4867",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ITZKOWITZ",
        "first_name": "FAY",
        "middle_name": "BERGER",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-08",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "029025",
            "primary": true
        },
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "NY",
            "license": "029025",
            "primary": false
        }
    ],
    "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 Jul 9, 2024; 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.