Individual provider Active NPI

Randi Ava Shebitz, M.S. OTR

  • Occupational Therapist
  • Tappan, NY
National Provider Identifier
1700196656
Registry record updated Oct 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
000928-1 Issued in NY
Practice address
140 Lester Dr
Tappan, NY 10983-1217
Phone
(845) 680-1301
NPI assigned
Oct 13, 2010
Last updated
Oct 13, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 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 000928-1 NY Primary

Addresses

Primary practice location

140 Lester Dr
Tappan, NY 10983-1217

Mailing address

140 Lester Dr
Tappan, NY 10983-1217
Phone (845) 680-1301

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)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
000928-1NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Early Childhood Program Past Accepting new patients

Organizations & group practices 1

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": "1286928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286928000000",
    "number": "1700196656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 LESTER DR",
            "city": "TAPPAN",
            "state": "NY",
            "postal_code": "109831217",
            "telephone_number": "845-680-1301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 LESTER DR",
            "city": "TAPPAN",
            "state": "NY",
            "postal_code": "109831217",
            "telephone_number": "845-680-1301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEBITZ",
        "first_name": "RANDI",
        "middle_name": "AVA",
        "credential": "M.S. OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-13",
        "last_updated": "2010-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "000928-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tappan, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2010; 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.