Active NPI
Mariya Fuzaylova, OTR/L
- Occupational Therapist
- Bronx, NY
National Provider Identifier
1700019783
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 013231
- Practice address
- 721 Melrose Ave
Bronx, NY 10455-1121 - Phone
- (718) 554-0064
- Fax
- (718) 554-0221
- NPI assigned
- Aug 25, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 013231 | NY | Primary |
Addresses
Primary practice location
721 Melrose Ave
Bronx, NY 10455-1121
Mailing address
721 Melrose Ave
Bronx, NY 10455-1121
Phone (718) 554-0064
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060210000282 | NY | Practitioner - Occupational Therapist in Private Practice | 2466467568 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Occupational Therapist in Private Practice
- Education
- Other, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Optimal Rehabilitation Otandpt PLLC
Practice addresses (Care Compare)
721 Melrose Ave
Bronx, NY 10455-1121
Phone (718) 554-0064
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 013231 | NY | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Optimal Rehabilitation OT&PT PLLC | Current | Accepting new patients | |
| Em Physical Therapy PC | Occupational Therapist | Past | Accepting new patients |
Locations
4011 Warren St
Ste 2
Elmhurst, NY 11373
Phone (516) 428-8364
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": "1251158400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1543190400000",
"number": "1700019783",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "721 MELROSE AVE",
"city": "BRONX",
"state": "NY",
"postal_code": "104551121",
"telephone_number": "718-554-0064",
"fax_number": "718-554-0221"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "721 MELROSE AVE",
"city": "BRONX",
"state": "NY",
"postal_code": "104551121",
"telephone_number": "718-554-0064",
"fax_number": "718-554-0221"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FUZAYLOVA",
"first_name": "MARIYA",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-08-25",
"last_updated": "2018-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "013231",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2018; 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.