Individual provider Active NPI

Charles J Allen, OTR/L,CHT

  • Occupational Therapist
  • Hauppauge, NY
National Provider Identifier
1548216237
Registry record updated Mar 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Practice address
2108 Joshuas Path
Hauppauge, NY 11788-4764
Phone
(631) 761-6996
Fax
(631) 761-6997
NPI assigned
May 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 1, 2024

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 Primary
Customized Equipment (DME) 332BC3200X

Addresses

Primary practice location

2108 Joshuas Path
Hauppauge, NY 11788-4764

Mailing address

20 Amber CT
Hauppauge, NY 11788-3107
Phone (631) 761-6996

Other practice location 1

290 E Main St Ste 400
Smithtown, NY 11787-2916
Phone (631) 675-5777

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040909001066 NY Practitioner - Occupational Therapist in Private Practice 8426024456 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2108 Joshuas Path
Hauppauge, NY 11788-4764
Phone (631) 761-6996

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
C.J. Allen OT Upper Extremity & Hand Therapy, PLLC Occupational Therapist CurrentSince Feb 11, 2015 Accepting new patients
C.J. Allen OT Upper Extremity & Hand Therapy, PLLC Occupational Therapist CurrentSince Jan 9, 2015 Accepting new patients
Bienetre Medical PC Occupational Therapist CurrentSince Dec 31, 2025 Accepting new patients

Locations

2108 Joshuas Path
Hauppauge, NY 11788
Phone (631) 265-0439

290 E Main St
Ste 400
Smithtown, NY 11787
Phone (631) 361-3325

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": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709251200000",
    "number": "1548216237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 AMBER CT",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "117883107",
            "telephone_number": "631-761-6996",
            "fax_number": "631-761-6997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2108 JOSHUAS PATH",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "117884764",
            "telephone_number": "631-761-6996",
            "fax_number": "631-761-6997"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "290 E Main St Ste 400",
            "address_purpose": "LOCATION",
            "city": "Smithtown",
            "state": "NY",
            "postal_code": "117872916",
            "country_code": "US",
            "telephone_number": "631-675-5777",
            "fax_number": "631-761-6997",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "CHARLES",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "OTR/L,CHT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-25",
        "last_updated": "2024-03-01",
        "certification_date": "2023-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hauppauge, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.