Individual provider Active NPI

Andrea E Bova, OTR/L

  • Pediatric Occupational Therapist
  • East Syracuse, NY
National Provider Identifier
1487985412
Registry record updated Sep 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
63 015988 Issued in NY
Practice address
6575 Kirkville Rd
East Syracuse, NY 13057-9809
Phone
(315) 701-5710
NPI assigned
Jan 14, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 63 015988 NY Primary

Addresses

Primary practice location

6575 Kirkville Rd
East Syracuse, NY 13057-9809

Mailing address

518 Bronson Rd
Syracuse, NY 13219-2206
Phone (315) 278-1243

Other practice location 1

1 Adler Dr
East Syracuse, NY 13057-1223
Phone (315) 701-7900

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
63 015988NYMDPediatric Occupational Therapist
015988NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hear 2 Learn PLLC Audiology and Speech/Language Pathology Pediatrics Past Accepting new patients

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": "1263427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537228800000",
    "number": "1487985412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "518 BRONSON RD",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132192206",
            "telephone_number": "315-278-1243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6575 KIRKVILLE RD",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130579809",
            "telephone_number": "315-701-5710"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Adler Dr",
            "address_purpose": "LOCATION",
            "city": "East Syracuse",
            "state": "NY",
            "postal_code": "130571223",
            "country_code": "US",
            "telephone_number": "315-701-7900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOVA",
        "first_name": "ANDREA",
        "middle_name": "E",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-14",
        "last_updated": "2018-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NY",
            "license": "63 015988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2018; 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.