Active NPI
Sara L Rutledge, OTR
- Pediatric Occupational Therapist
- Massapequa, NY
National Provider Identifier
1477678753
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- 003247
- Practice address
- 100 Hicksville Rd
Massapequa, NY 11758-5823 - Phone
- (516) 799-2900
- Fax
- (516) 799-2928
- NPI assigned
- Mar 19, 2007
- Last updated
- May 21, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | 003247 | CT | Primary |
| Pediatric Occupational Therapist | 225XP0200X | 015316 | NY |
Addresses
Primary practice location
100 Hicksville Rd
Massapequa, NY 11758-5823
Mailing address
100 Hicksville Rd
Massapequa, NY 11758-5823
Phone (516) 799-2900
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 015316 | Other | NY | NY STATE OCCUPATIONAL THERAPY LICENSE |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 003247 | CT | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sensational Development OT, PLLC | Past | Accepting new patients | |
| Sensational Development OT, PLLC | Pediatrics | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Occupational Therapist
- Massapequa, NY
- NPI 1447017074
-
- Pediatric Occupational Therapist
- Massapequa, NY
- NPI 1750625703
Pediatrics
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174262400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1274400000000",
"number": "1477678753",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 HICKSVILLE RD",
"city": "MASSAPEQUA",
"state": "NY",
"postal_code": "117585823",
"telephone_number": "516-799-2900",
"fax_number": "516-799-2928"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 HICKSVILLE RD",
"city": "MASSAPEQUA",
"state": "NY",
"postal_code": "117585823",
"telephone_number": "516-799-2900",
"fax_number": "516-799-2928"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUTLEDGE",
"first_name": "SARA",
"middle_name": "L",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-19",
"last_updated": "2010-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "CT",
"license": "003247",
"primary": true
},
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "NY",
"license": "015316",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NY STATE OCCUPATIONAL THERAPY LICENSE",
"identifier": "015316",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Massapequa, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.