Individual provider Active NPI

Lucy Fe Miraflor Ello

  • Occupational Therapist
  • New York, NY
National Provider Identifier
1619360591
Registry record updated Mar 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
180261 Issued in NY
Practice address
575 8TH Ave FL 6
New York, NY 10018-3158
Phone
(917) 657-4654
NPI assigned
Mar 16, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2015

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 180261 NY Primary

Addresses

Primary practice location

575 8TH Ave FL 6
New York, NY 10018-3158

Mailing address

575 8TH Ave FL 6
New York, NY 10018-3158
Phone (917) 657-4654

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260623005038 NJ Practitioner - Occupational Therapist in Private Practice 3779815170 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2012
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1137 Charlotte PL
Rahway, NJ 07065-2727

385 Clinton Ave
Wyckoff, NJ 07481-1969

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
018026NYMDPsychologist
180261NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prokinetics Physical Therapy P.C. PastSince Jul 5, 2023 Accepting new patients

Organizations & group practices 2

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": "1426464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426464000000",
    "number": "1619360591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 8TH AVE FL 6",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100183158",
            "telephone_number": "917-657-4654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 8TH AVE FL 6",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100183158",
            "telephone_number": "917-657-4654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLO",
        "first_name": "LUCY FE",
        "middle_name": "MIRAFLOR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-16",
        "last_updated": "2015-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "180261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2015; 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.