NPIMap

Organization Active NPI

Professional Occupational & Physical Therapy, PLLC

  • Occupational Therapist
  • Farmingdale, NY
National Provider Identifier
1700685898
Registry record updated Mar 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Legal business name
PROFESSIONAL OCCUPATIONAL & PHYSICAL THERAPY, PLLC
Practice address
234 Airport Plaza Blvd Ste 2
2ND FL Ste 11D
Farmingdale, NY 11735-3936
Phone
(631) 270-5977
Fax
(631) 270-5970
NPI assigned
Mar 11, 2025
Last updated
Mar 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Alexa Merlos
Title
Credentialing Coordinator
Phone
(631) 359-5859

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X Primary

Addresses

Primary practice location

234 Airport Plaza Blvd Ste 2
2ND FL Ste 11D
Farmingdale, NY 11735-3936

Mailing address

576 Broadhollow Rd
Melville, NY 11747-5012

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250501002908 NY DME Supplier - Independently-Practicing Occupational Therapist 3779873401 Practice locations: Farmingdale, NY

National Provider Directory

National Provider Directory
Tax ID family
Prof Occupational Phyl THP120 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1741651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741651200000",
    "number": "1700685898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "576 BROADHOLLOW RD",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117475012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 AIRPORT PLAZA BLVD STE 2",
            "address_2": "2ND FL STE 11D",
            "city": "FARMINGDALE",
            "state": "NY",
            "postal_code": "117353936",
            "telephone_number": "631-270-5977",
            "fax_number": "631-270-5970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL OCCUPATIONAL & PHYSICAL THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-11",
        "last_updated": "2025-03-11",
        "certification_date": "2025-03-11",
        "status": "A",
        "authorized_official_last_name": "MERLOS",
        "authorized_official_first_name": "ALEXA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "631-359-5859"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmingdale, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2025; 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.