Individual provider Active NPI

Antoinette Simonetti, OTR/L

  • Pediatric Occupational Therapist
  • Staten Island, NY
National Provider Identifier
1639314404
Registry record updated Dec 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
012692 Issued in NY
Practice address
97 Churchill Ave
Staten Island, NY 10309-1921
Phone
(718) 317-0596
NPI assigned
Dec 9, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 012692 NY Primary

Addresses

Primary practice location

97 Churchill Ave
Staten Island, NY 10309-1921

Mailing address

97 Churchill Ave
Staten Island, NY 10309-1921
Phone (718) 317-0596

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

NPI Registry JSON

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

{
    "created_epoch": "1228780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228780800000",
    "number": "1639314404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "97 CHURCHILL AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103091921",
            "telephone_number": "718-317-0596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "97 CHURCHILL AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103091921",
            "telephone_number": "718-317-0596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMONETTI",
        "first_name": "ANTOINETTE",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-09",
        "last_updated": "2008-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NY",
            "license": "012692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2008; 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.