Individual provider Active NPI

Brianna Nicole Westfall, OTR/L

  • Occupational Therapist
  • Great Neck, NY
National Provider Identifier
1679148282
Registry record updated Jun 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
025611-01 Issued in NY
Practice address
475 Northern Blvd Ste 19
Great Neck, NY 11021-4802
Phone
(516) 829-0030
Fax
(516) 466-7723
NPI assigned
May 25, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2021

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 025611-01 NY Primary

Addresses

Primary practice location

475 Northern Blvd Ste 19
Great Neck, NY 11021-4802

Mailing address

475 Northern Blvd Ste 19
Great Neck, NY 11021-4802
Phone (516) 829-0030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210608000890 NY Practitioner - Occupational Therapist in Private Practice 8426458704 Reassigns benefits to 2 organizations
I20240701001916 NJ Practitioner - Occupational Therapist in Private Practice 8426458704 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
025611-01NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Rehabilitation Physical Therapy Services LLC Occupational Therapist CurrentSince Jul 1, 2022 Accepting new patients
Reddy Care Physical and Occupational Therapy PLLC CurrentSince May 25, 2021 Accepting new patients
Fox Rehabilitation Services Inc Occupational Therapist CurrentSince Jun 1, 2024 Accepting new patients
Reddy Care Physical Therapy PC PastSince May 25, 2021 Accepting new patients

Locations

872 E Main St
Bridgewater, NJ 08807
Phone (908) 725-2995

7 Carnegie Plz
Cherry Hill, NJ 08003

407 W Delilah Rd
Pleasantville, NJ 08232
Phone (609) 289-2331

475 Northern Blvd
Ste 19
Great Neck, NY 11021
Phone (516) 344-0023

475 Northern Blvd
Ste 27
Great Neck, NY 11021

1415 Richmond Ave
Staten Island, NY 10314
Phone (212) 475-5540

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1621900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622764800000",
    "number": "1679148282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 NORTHERN BLVD STE 19",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110214802",
            "telephone_number": "516-829-0030",
            "fax_number": "516-466-7723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 NORTHERN BLVD STE 19",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110214802",
            "telephone_number": "516-829-0030",
            "fax_number": "516-466-7723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WESTFALL",
        "first_name": "BRIANNA",
        "middle_name": "NICOLE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-25",
        "last_updated": "2021-06-04",
        "certification_date": "2021-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "025611-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Neck, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.