Organization Active NPI

Forward Occupational Therapy PLLC

  • Occupational Therapist
  • Brooklyn, NY
National Provider Identifier
1558638957
Registry record updated Nov 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
013333-1 Issued in NY
Legal business name
FORWARD OCCUPATIONAL THERAPY PLLC
Practice address
3815 13TH Ave
Brooklyn, NY 11218
Phone
(718) 677-6777
Fax
(718) 338-9506
NPI assigned
Nov 30, 2011
Last updated
Nov 30, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2011

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

Authorized official

Name
Mrs. Robin Akselrud, MS, OTR/LNPI 1972758340
Title
Owner
Phone
(917) 689-7925

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 013333-1 NY Primary

Addresses

Primary practice location

3815 13TH Ave
Brooklyn, NY 11218

Mailing address

1546 E 31St St
Brooklyn, NY 11234-3402
Phone (917) 689-7925

Other identifiers 1

IdentifierTypeStateIssuer
03378530MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120203000115 NY Part B Supplier - Clinic/Group Practice 2769649714 Receives reassigned benefits from 3 practitioners
Practice locations: Brooklyn, NY; Rockaway Park, NY

National Provider Directory

National Provider Directory

Locations

5327 18th Ave
Brooklyn, NY 11204
Phone (718) 236-7707

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1322611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322611200000",
    "number": "1558638957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1546 E 31ST ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112343402",
            "telephone_number": "917-689-7925",
            "fax_number": "718-338-9506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3815 13TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11218",
            "telephone_number": "718-677-6777",
            "fax_number": "718-338-9506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORWARD OCCUPATIONAL THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-30",
        "last_updated": "2011-11-30",
        "status": "A",
        "authorized_official_last_name": "AKSELRUD",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-689-7925",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MS, OTR/L"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "013333-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03378530",
            "state": "NY"
        }
    ],
    "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 Nov 30, 2011; 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.