Individual provider Active NPI

Mohamed Serour, COTA/L

  • Occupational Therapy Assistant
  • New York, NY
National Provider Identifier
1629904057
Registry record updated Jun 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
011816-01 Issued in NY
Practice address
1 Nagle Ave
New York, NY 10040-1405
Phone
(212) 928-7800
NPI assigned
Jun 23, 2026
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 011816-01 NY Primary

Addresses

Primary practice location

1 Nagle Ave
New York, NY 10040-1405

Mailing address

505 57TH St Apt 36
West New York, NJ 07093-1272
Phone (201) 397-9319

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Theradynamics Rehab. PT, OT & SLP, PLLC PastSince Oct 15, 2022 Accepting new patients

Organizations & group practices 1

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": "1782172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782172800000",
    "number": "1629904057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 57TH ST APT 36",
            "city": "WEST NEW YORK",
            "state": "NJ",
            "postal_code": "070931272",
            "telephone_number": "201-397-9319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 NAGLE AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100401405",
            "telephone_number": "212-928-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEROUR",
        "first_name": "MOHAMED",
        "credential": "COTA/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-06-23",
        "last_updated": "2026-06-23",
        "certification_date": "2026-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NY",
            "license": "011816-01",
            "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 Jun 23, 2026; 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.