Active NPI
Juan Manuel Escobar, OTR
- Occupational Therapist
- Watervliet, NY
National Provider Identifier
1508061706
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 46TR00426500
- Practice address
- 317 Boght Rd
Watervliet, NY 12189-1106 - Phone
- (850) 624-4010
- NPI assigned
- Jun 18, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 46TR00426500 | NJ | Primary |
Addresses
Primary practice location
317 Boght Rd
Watervliet, NY 12189-1106
Mailing address
317 Boght Rd
Watervliet, NY 12189-1106
Phone (850) 624-4010
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230517002457 | NY | Practitioner - Occupational Therapist in Private Practice | 9830555838 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 46TR00426500 | NJ | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182124800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1681257600000",
"number": "1508061706",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "317 BOGHT RD",
"city": "WATERVLIET",
"state": "NY",
"postal_code": "121891106",
"telephone_number": "850-624-4010"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "317 BOGHT RD",
"city": "WATERVLIET",
"state": "NY",
"postal_code": "121891106",
"telephone_number": "850-624-4010"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ESCOBAR",
"first_name": "JUAN",
"middle_name": "MANUEL",
"credential": "OTR",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-06-18",
"last_updated": "2023-04-12",
"certification_date": "2023-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NJ",
"license": "46TR00426500",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Watervliet, NY
- Maria Anne Duffany
- Tahir Effendi, M.D.
- Uchechukwu Egboluche, PHARMD
- Emanvi LLC (Escobar Occupational Therapy Consulting and Services)
- Empire Fitness & Physical Therapy (Empire Health & Wellness Center)
- Jenna G Frank
- Heather A Gansky, IBCLC
- Amber Garrow, PHARMD
- Gattu N. Rao, P.C.
- Janice Marie Gauriloff
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.