Individual provider Active NPI

Elea R Bushati

  • Occupational Therapist
  • Hamden, CT
National Provider Identifier
1508341256
Registry record updated Mar 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5869 Issued in CT
Practice address
2666 State St Ste A3
Hamden, CT 06517-2232
Phone
(888) 754-0398
NPI assigned
Sep 28, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 5869 CT Primary
Mental Health Counselor 101YM0800X

Addresses

Primary practice location

2666 State St Ste A3
Hamden, CT 06517-2232

Mailing address

193 Mountain View Rd
Somers, CT 06071-2230
Phone (516) 469-8155

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240715003041 CA Practitioner - Occupational Therapist in Private Practice 8628513546 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5869CTMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Monterey Bay Speech Therapy, Inc. Occupational Therapist CurrentSince Jul 11, 2024 Accepting new patients
The May Institute, Inc Past Accepting new patients
The May Institute, Inc Past Accepting new patients

Locations

667 Lighthouse Ave
Ste 305
Pacific Grove, CA 93950
Phone (831) 318-0558

667 Lighthouse Ave
Ste 201
Pacific Grove, CA 93950
Phone (831) 204-0019

Organizations & group practices 3

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": "1538092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680220800000",
    "number": "1508341256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "193 MOUNTAIN VIEW RD",
            "city": "SOMERS",
            "state": "CT",
            "postal_code": "060712230",
            "telephone_number": "516-469-8155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2666 STATE ST STE A3",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065172232",
            "telephone_number": "888-754-0398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSHATI",
        "first_name": "ELEA",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-28",
        "last_updated": "2023-03-31",
        "certification_date": "2023-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CT",
            "license": "5869",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamden, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 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.

Verify at the official NPI Registry.