Individual provider Active NPI

Michael David Carroll, OTR/L

  • Occupational Therapist
  • New York, NY
National Provider Identifier
1457092603
Registry record updated Apr 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
026685 Issued in NY
Practice address
245 E 84TH St
New York, NY 10028-2973
Phone
(646) 841-1414
Fax
(212) 379-2122
NPI assigned
Apr 3, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2022

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 026685 NY Primary

Addresses

Primary practice location

245 E 84TH St
New York, NY 10028-2973

Mailing address

31 E 32ND St
New York, NY 10016-5509
Phone (212) 759-2282

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220531001618 NY Practitioner - Occupational Therapist in Private Practice 9931587136 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2465 Broadway
New York, NY 10025-7486
Phone (212) 759-2282

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
026685NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Spear Physical and Occupational Therapy, LLC Occupational Therapist CurrentSince May 19, 2022 Accepting new patients

Locations

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

245 E 84th St
New York, NY 10028
Phone (212) 876-5400

2465 Broadway
New York, NY 10025
Phone (212) 712-1000

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

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": "1648944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648944000000",
    "number": "1457092603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 E 32ND ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100165509",
            "telephone_number": "212-759-2282",
            "fax_number": "212-379-2123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 E 84TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100282973",
            "telephone_number": "646-841-1414",
            "fax_number": "212-379-2122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "MICHAEL",
        "middle_name": "DAVID",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-03",
        "last_updated": "2022-04-03",
        "certification_date": "2022-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "026685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2022; 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.