Individual provider Active NPI

Kristin Mari Wong

  • Occupational Therapist
  • Brooklyn, NY
National Provider Identifier
1700533601
Registry record updated Mar 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
025989 Issued in NY
Practice address
2579 Ocean Ave FL 3
Brooklyn, NY 11229-4552
Phone
(646) 780-0926
NPI assigned
Mar 9, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2022

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 025989 NY Primary

Addresses

Primary practice location

2579 Ocean Ave FL 3
Brooklyn, NY 11229-4552

Mailing address

7522 Kingsbury PL
Cupertino, CA 95014-5045

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220425000279 NY Practitioner - Occupational Therapist in Private Practice 8426445339 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prestige Rehab LLCGroup PAC ID 3375936495, 59 clinicians

Practice addresses (Care Compare)

16 W 16TH St
Apt 4PN
New York, NY 10011-0173
Phone (855) 678-8887

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
025989NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Prestige Rehab LLC Occupational Therapist CurrentSince Mar 19, 2025 Accepting new patients
New York Physical and Occupational Therapy Services, PLLC Occupational Therapist CurrentSince Mar 24, 2022 Accepting new patients
Prestige Rehab Ny LLC Occupational Therapist CurrentSince Mar 19, 2025 Accepting new patients

Locations

54 State St
Ste 804
Albany, NY 12207
Phone (347) 581-2357

2579 Ocean Ave
Fl 3
Brooklyn, NY 11229
Phone (646) 780-0925

Organizations & group practices 3

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": "1646784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646784000000",
    "number": "1700533601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7522 KINGSBURY PL",
            "city": "CUPERTINO",
            "state": "CA",
            "postal_code": "950145045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2579 OCEAN AVE FL 3",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112294552",
            "telephone_number": "646-780-0926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "KRISTIN",
        "middle_name": "MARI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-09",
        "last_updated": "2022-03-09",
        "certification_date": "2022-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "025989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2022; 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.