Individual provider Active NPI

Miriam Lichter, OT

  • Occupational Therapist
  • Far Rockaway, NY
National Provider Identifier
1629169313
Registry record updated Jul 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
008914-1 Issued in NY
Practice address
910 Seagirt Blvd
Far Rockaway, NY 11691-5632
Phone
(917) 593-7389
NPI assigned
Sep 27, 2006
Last updated
Jul 18, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2011

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 008914-1 NY Primary

Addresses

Primary practice location

910 Seagirt Blvd
Far Rockaway, NY 11691-5632

Mailing address

910 Seagirt Blvd
Far Rockaway, NY 11691-5632
Phone (917) 593-7389

Other identifiers 1

IdentifierTypeStateIssuer
008914-1OtherNYLICENSE#

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060207000360 NY Practitioner - Occupational Therapist in Private Practice 0143235572 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
008914NYMDMental Health Counselor
008914-1NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Ahava Medical and Rehabilitation Center, LLC CurrentSince Jan 1, 2010 Accepting new patients
Mermaid Operating Co, LLC PastSince Nov 4, 2005 Accepting new patients
United Physical Therapy PC Occupational Therapist PastSince Sep 15, 2012 Accepting new patients

Locations

16 Sumner Pl
Brooklyn, NY 11206
Phone (718) 336-9500

2555 Nostrand Ave
Brooklyn, NY 11210
Phone 7189518800108

Networks

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

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, 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": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310947200000",
    "number": "1629169313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 SEAGIRT BLVD",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116915632",
            "telephone_number": "917-593-7389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 SEAGIRT BLVD",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116915632",
            "telephone_number": "917-593-7389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LICHTER",
        "first_name": "MIRIAM",
        "credential": "OT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2011-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "008914-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE#",
            "identifier": "008914-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Far Rockaway, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 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.