Individual provider Active NPI

Dmitry Shevchenko, OTR/L

  • Occupational Therapist
  • Brooklyn, NY
National Provider Identifier
1578974473
Registry record updated Aug 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
018851-1 Issued in NY
Practice address
174 Bay 29TH St # C2
Brooklyn, NY 11214-5020
Phone
(347) 766-9077
Fax
(718) 889-6707
NPI assigned
May 13, 2014
Last updated
Aug 26, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2025

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 018851-1 NY Primary

Addresses

Primary practice location

174 Bay 29TH St # C2
Brooklyn, NY 11214-5020

Mailing address

3030 Emmons Ave Apt 5T
Brooklyn, NY 11235-2228
Phone (347) 766-9077

Other names 1

  • Dmitry Shevchenko Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160330000625 NY Practitioner - Occupational Therapist in Private Practice 8921305392 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
High Impact Occupational Therapy PCGroup PAC ID 0345539755, 2 clinicians

Practice addresses (Care Compare)

288 Sand LN
Suite 1
Staten Island, NY 10305-4512
Phone (347) 766-9077

93 Abingdon Ave
Staten Island, NY 10308-2202
Phone (347) 733-1774

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
018851-1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Provider Rehab, OT. P.C. Occupational Therapist CurrentSince May 15, 2017 Accepting new patients
Rehab on Wheels OT PT PLLC Occupational Therapist CurrentSince Aug 4, 2017 Accepting new patients
Chelsea Physical Therapy PLLC CurrentSince Dec 26, 2025 Accepting new patients
High Impact Occupational Therapy PC Occupational Therapist CurrentSince Mar 1, 2017 Accepting new patients
D and H PT OT PLLC Occupational Therapist CurrentSince Dec 26, 2025 Accepting new patients
Ability HR Hand Therapy, OT and PT PLLC Occupational Therapist CurrentSince Jan 26, 2016 Accepting new patients
Prokinetics Physical Therapy P.C. PastSince Jul 5, 2023 Accepting new patients

Locations

174 Bay 29th St
#C2
Brooklyn, NY 11214
Phone (718) 395-7445

174 Bay 29th St
Ste C1
Brooklyn, NY 11214
Phone (646) 750-4455

2632 E 21st St
Ste 2
Brooklyn, NY 11235
Phone (718) 368-3494

813 Quentin Rd
Ste 106
Brooklyn, NY 11223
Phone (718) 506-9663

8419 Bay Pkwy
Brooklyn, NY 11214
Phone (718) 259-0199

359 W 23rd St
New York, NY 10011
Phone (212) 488-7300

110 Henderson Ave
Staten Island, NY 10301
Phone (718) 375-3746

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1399939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756166400000",
    "number": "1578974473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3030 EMMONS AVE APT 5T",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112352228",
            "telephone_number": "347-766-9077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "174 BAY 29TH ST # C2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112145020",
            "telephone_number": "347-766-9077",
            "fax_number": "718-889-6707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEVCHENKO",
        "first_name": "DMITRY",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-05-13",
        "last_updated": "2025-08-26",
        "certification_date": "2025-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "018851-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DMITRY",
            "last_name": "SHEVCHENKO",
            "credential": "OTR/L",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Aug 26, 2025; 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.