Individual provider Active NPI

Nicole Marie Cusumano, OTR L

  • Occupational Therapist
  • Brooklyn, NY
National Provider Identifier
1508952938
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
010626-1 Issued in NY
Practice address
50 Court St
9TH Floor
Brooklyn, NY 11201-4859
Phone
(718) 855-7707
NPI assigned
Oct 5, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 010626-1 NY Primary

Addresses

Primary practice location

50 Court St
9TH Floor
Brooklyn, NY 11201-4859

Mailing address

633 W Market St
Long Beach, NY 11561-1718
Phone (917) 603-6503

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
010626-1NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Heartshare Wellness, LTD. 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": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508952938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "633 W MARKET ST",
            "city": "LONG BEACH",
            "state": "NY",
            "postal_code": "115611718",
            "telephone_number": "917-603-6503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 COURT ST",
            "address_2": "9TH FLOOR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112014859",
            "telephone_number": "718-855-7707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUSUMANO",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "OTR L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "010626-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.