Individual provider Active NPI

Tracy Camacho, OTR/L

  • Occupational Therapist
  • Valley Stream, NY
National Provider Identifier
1659674968
Registry record updated Jul 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
016784 Issued in NY
Practice address
1121 Ashley Dr
Valley Stream, NY 11580-2431
Phone
(516) 285-6594
NPI assigned
Dec 8, 2010
Last updated
Jul 11, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2011

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 016784 NY Primary

Addresses

Primary practice location

1121 Ashley Dr
Valley Stream, NY 11580-2431

Mailing address

1121 Ashley Dr
Valley Stream, NY 11580-2431
Phone (516) 285-6594

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
016784NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Camacho's Purposeful Occupational Therapy, P.C. Past Accepting new patients
Avenue S Rehab PT PC Past Accepting new patients
Reliance Healthcare Occupational Therapist Past Accepting new patients
Genesis Medical Health PC Past Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1291766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310342400000",
    "number": "1659674968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1121 ASHLEY DR",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115802431",
            "telephone_number": "516-285-6594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 ASHLEY DR",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115802431",
            "telephone_number": "516-285-6594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMACHO",
        "first_name": "TRACY",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-08",
        "last_updated": "2011-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "016784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley Stream, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2011; 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.