Individual provider Active NPI

Kevin Michael Heller, MS, OTR/L

  • Occupational Therapist
  • New Hyde Park, NY
National Provider Identifier
1447555248
Registry record updated Mar 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
017028 Issued in NY
Practice address
5 Dakota Dr
Suite 200
New Hyde Park, NY 11042-1107
Phone
(516) 729-4301
NPI assigned
Jan 26, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2013

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 017028 NY Primary

Addresses

Primary practice location

5 Dakota Dr
Suite 200
New Hyde Park, NY 11042-1107

Mailing address

5 Dakota Dr
Suite 200
New Hyde Park, NY 11042-1107
Phone (516) 729-4301

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
017028NYMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1296000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362268800000",
    "number": "1447555248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 DAKOTA DR",
            "address_2": "SUITE 200",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421107",
            "telephone_number": "516-729-4301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 DAKOTA DR",
            "address_2": "SUITE 200",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421107",
            "telephone_number": "516-729-4301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HELLER",
        "first_name": "KEVIN",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "MS, OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-01-26",
        "last_updated": "2013-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "017028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hyde Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2013; 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.