Katie Surdam

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

007797-1 Issued in NY

Practice address

5 Mallard Dr
Newburgh, NY 12550-8769

Phone

(845) 476-1661

NPI assigned

Nov 2, 2016

Last updated

Nov 2, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• OT, PT, SLP and RN PLLC

  dba Therapeutic Horizons

  • Personal Care Attendant
  • Newburgh, NY
  • NPI 1699121400
  NPD (past)

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

{
    "created_epoch": "1478044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478044800000",
    "number": "1467904888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 FLEETWOOD DR",
            "city": "WAPPINGERS FALLS",
            "state": "NY",
            "postal_code": "125905317",
            "telephone_number": "845-590-2677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 MALLARD DR",
            "city": "NEWBURGH",
            "state": "NY",
            "postal_code": "125508769",
            "telephone_number": "845-476-1661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SURDAM",
        "first_name": "KATIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-02",
        "last_updated": "2016-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NY",
            "license": "007797-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Sullivan
• Kailee Elizabeth Sullivan, PT, DPT
• Meagan Sullivan
• Richard Michael Sullivan, LCSW-R
• Sunshine Adult Social Day Care Inc.
• Suchith Boodgere Suresh
• Shivani Rajeshkumar Suthar, PT
• Stanley Swaby
• Mark Swed, MD
• Steven G Sweitzer, P.A.

• Occupational Therapy Assistant in Newburgh, NY
• Providers in Newburgh, NY by specialty
• Occupational Therapy Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2016; 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.