Individual provider Active NPI

Anna Ivasyuk

  • Occupational Therapy Assistant
  • Brooklyn, NY
National Provider Identifier
1528640752
Registry record updated Apr 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
010743 Issued in NY
Practice address
2955 Brighton 4TH St
Brooklyn, NY 11235-8533
Phone
(718) 332-0080
NPI assigned
Apr 27, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 010743 NY Primary

Addresses

Primary practice location

2955 Brighton 4TH St
Brooklyn, NY 11235-8533

Mailing address

1750 W 9TH St
Brooklyn, NY 11223-1239
Phone (609) 357-8902

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": "1619481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619481600000",
    "number": "1528640752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 W 9TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112231239",
            "telephone_number": "609-357-8902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2955 BRIGHTON 4TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112358533",
            "telephone_number": "718-332-0080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVASYUK",
        "first_name": "ANNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-27",
        "last_updated": "2021-04-27",
        "certification_date": "2021-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NY",
            "license": "010743",
            "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 Apr 27, 2021; 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.