Tara Walsh, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Practice address

560 Broadhollow Rd Ste 304
Melville, NY 11747-3702

Phone

(516) 222-2010

NPI assigned

Mar 21, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Tara Derudder Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Rehabpro Physical Therapy, PC

  • Physical Therapist
  • Melville, NY
  • NPI 1154355444
  NPD
• Propel Physical Therapy PC

  • Physical Therapist
  • Greenvale, NY
  • NPI 1619519972

  Occupational Therapist

  NPD (past)

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

{
    "created_epoch": "1647820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647820800000",
    "number": "1578212296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 OLDFIELD AVE",
            "city": "AMITYVILLE",
            "state": "NY",
            "postal_code": "117013126",
            "telephone_number": "631-365-4358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 BROADHOLLOW RD STE 304",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117473702",
            "telephone_number": "516-222-2010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALSH",
        "first_name": "TARA",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-21",
        "last_updated": "2022-03-21",
        "certification_date": "2022-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "N/A",
            "identifier": "00000",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "WebPT.com",
            "affiliation": "Y",
            "affiliationName": "Optimum Therapeutics PT & OT PLLC",
            "address_1": "560 Broadhollow Rd Ste 304",
            "city": "Melville",
            "state": "NY",
            "country_code": "US",
            "postal_code": "117473702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "TARA",
            "last_name": "DERUDDER",
            "credential": "OTR/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Karen Walker
• Shawanda Walker
• Algernon Anthony Stephen Waller
• Nichole Walling
• Amanda Rizzo Walsh, MD, MS
• Walt Whitman Aa, LLC
• Alyssa Walter
• Samantha Walter
• Laine Walterson
• Lauren Wandy, LCSW

• Occupational Therapist in Melville, NY
• Providers in Melville, NY by specialty
• Occupational Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2022; 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.