Individual provider Active NPI

Nino Antonio Vidal Sarvida, OT

  • Occupational Therapist
  • Staten Island, NY
National Provider Identifier
1649502188
Registry record updated Feb 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
013969-1 Issued in NY
Practice address
361 Edison St
Staten Island, NY 10306-3043
Phone
(718) 980-0101
Fax
(718) 980-1641
NPI assigned
Feb 9, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2010

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 013969-1 NY Primary

Addresses

Primary practice location

361 Edison St
Staten Island, NY 10306-3043

Mailing address

361 Edison St
Staten Island, NY 10306-3043
Phone (718) 980-0101

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260327000661 NY Practitioner - Occupational Therapist in Private Practice 0749765816 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2324 Forest Ave
Staten Island, NY 10303-1506
Phone (718) 447-0200

801 Merrick Ave
East Meadow, NY 11554-4748
Phone (516) 393-8900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
013969-1NYMDDermatology Physician

Organizations & group practices 2

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": "1265673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265673600000",
    "number": "1649502188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "361 EDISON ST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103063043",
            "telephone_number": "718-980-0101",
            "fax_number": "718-980-1641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "361 EDISON ST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103063043",
            "telephone_number": "718-980-0101",
            "fax_number": "718-980-1641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SARVIDA",
        "first_name": "NINO",
        "middle_name": "ANTONIO VIDAL",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-02-09",
        "last_updated": "2010-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "013969-1",
            "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 Feb 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.