Individual provider Active NPI

Fortuna Rashid Anannya, OTR/L

  • Occupational Therapist
  • East Setauket, NY
National Provider Identifier
1447076450
Registry record updated Nov 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Practice address
16 18TH St
East Setauket, NY 11733-1094
Phone
(718) 690-4185
NPI assigned
Nov 25, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 25, 2024

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 Primary

Addresses

Primary practice location

16 18TH St
East Setauket, NY 11733-1094

Mailing address

16 18TH St
East Setauket, NY 11733-1094
Phone (718) 690-4185

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241204001403 NY Practitioner - Occupational Therapist in Private Practice 3274069026 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
028949NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Metro Physical Occupational Speech Massage Therapy & Acupuncture PLLC Occupational Therapist CurrentSince Nov 14, 2024 Accepting new patients

Locations

800 E Gate Blvd
Garden City, NY 11530

50 Glen Cove Rd
Greenvale, NY 11548
Phone (516) 200-3545

11701 84th Ave
Richmond Hill, NY 11418
Phone (718) 441-0300

1312 Middle Country Rd
Selden, NY 11784
Phone (631) 698-6556

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": "1732492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732492800000",
    "number": "1447076450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 18TH ST",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117331094",
            "telephone_number": "718-690-4185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 18TH ST",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117331094",
            "telephone_number": "718-690-4185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANANNYA",
        "first_name": "FORTUNA",
        "middle_name": "RASHID",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-25",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Setauket, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2024; 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.