Individual provider Active NPI

Stephanie Marie Diogo, OTR/L

  • Occupational Therapist
  • Goshen, NY
National Provider Identifier
1639640709
Registry record updated May 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
023131 Issued in NY
Practice address
2 Fletcher St
Goshen, NY 10924-1402
Phone
(914) 428-5151
NPI assigned
Dec 16, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2024

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 023131 NY Primary

Addresses

Primary practice location

2 Fletcher St
Goshen, NY 10924-1402

Mailing address

75 Crystal Run Rd Ste 201
Middletown, NY 10941-7010
Phone (845) 692-4391

Other practice location 1

75 Crystal Run Rd Ste 201
Middletown, NY 10941-7010
Phone (845) 692-4391

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

State licenses

LicenseStateTypeSpecialty
023131NYMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1544918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715299200000",
    "number": "1639640709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 CRYSTAL RUN RD STE 201",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109417010",
            "telephone_number": "845-692-4391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 FLETCHER ST",
            "city": "GOSHEN",
            "state": "NY",
            "postal_code": "109241402",
            "telephone_number": "914-428-5151"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "75 Crystal Run Rd Ste 201",
            "address_purpose": "LOCATION",
            "city": "Middletown",
            "state": "NY",
            "postal_code": "109417010",
            "country_code": "US",
            "telephone_number": "845-692-4391",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIOGO",
        "first_name": "STEPHANIE",
        "middle_name": "MARIE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-16",
        "last_updated": "2024-05-10",
        "certification_date": "2024-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "023131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goshen, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2024; 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.