Individual provider Active NPI

Drew Pottheiser, OTR/L

  • Occupational Therapist
  • Staten Island, NY
National Provider Identifier
1497007611
Registry record updated Oct 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
017283-1 Issued in NY
Practice address
3936 Amboy Rd
Staten Island, NY 10308-2406
Phone
(718) 317-6390
NPI assigned
Oct 11, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2012

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 017283-1 NY Primary

Addresses

Primary practice location

3936 Amboy Rd
Staten Island, NY 10308-2406

Mailing address

234 McBaine Ave
Staten Island, NY 10309-1611
Phone (917) 670-8633

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

NPI Registry JSON

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

{
    "created_epoch": "1349913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349913600000",
    "number": "1497007611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "234 MCBAINE AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103091611",
            "telephone_number": "917-670-8633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3936 AMBOY RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103082406",
            "telephone_number": "718-317-6390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTTHEISER",
        "first_name": "DREW",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-11",
        "last_updated": "2012-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "017283-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2012; 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.