Origins Integrative Occupational Therapy PLLC

Primary specialty

Rehabilitation Clinic/CenterTaxonomy code 261QR0400X

Legal business name

ORIGINS INTEGRATIVE OCCUPATIONAL THERAPY PLLC

Practice address

21343 35TH Ave FL 2
Bayside, NY 11361-1750

Phone

(631) 252-8167

NPI assigned

Nov 20, 2023

Organization subpart

No

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

Authorized official

Name

Mr. Matthew F Rosenboom, OTR/LNPI 1760918064

Title

Ceo

Phone

(631) 252-8167

Specialties & licenses 1

Addresses

Other names 1

• Life Lifters Health Occupational Therapy Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Matthew Rosenboom

  • Children's Hospital
  • New Hyde Park, NY
  • NPI 1760918064
  NPD Authorized official

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

{
    "created_epoch": "1700438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700438400000",
    "number": "1639944705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 NEW YORK AVE",
            "city": "SOUND BEACH",
            "state": "NY",
            "postal_code": "117892250",
            "telephone_number": "631-252-8167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21343 35TH AVE FL 2",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113611750",
            "telephone_number": "631-252-8167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORIGINS INTEGRATIVE OCCUPATIONAL THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-20",
        "last_updated": "2023-11-20",
        "certification_date": "2023-11-19",
        "status": "A",
        "authorized_official_last_name": "ROSENBOOM",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "631-252-8167",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Life Lifters Health Occupational Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ion Oltean, MD
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• Coleen Charlotte Rabe Ong, MPT
• Oral & Maxillofacial Surgery Associates, PC
• Orasis Laser LLC
• Susan Ornstein-Nonnon
• Kimberly Caty Ortega
• Brianna Enid Osbourn, MS, OTR/L
• Amanda Osman, LMHC
• Julia Oster, M.D

• Rehabilitation Clinic/Center in Bayside, NY
• Providers in Bayside, NY by specialty
• Rehabilitation Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2023; 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.