Individual provider Active NPI

Suzie Dorsainvil, OCCUP. THERAPIST

  • Pediatric Occupational Therapist
  • Valley Stream, NY
National Provider Identifier
1710130869
Registry record updated Nov 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
004989 Issued in NY
Practice address
39 Molyneaux Rd
Valley Stream, NY 11580-1925
Phone
(516) 561-9522
Fax
(516) 561-9522
NPI assigned
Nov 1, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2008

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Occupational Therapist 225XG0600X 004989 NY
Physical Rehabilitation Occupational Therapist 225XP0019X 004989 NY
Pediatric Occupational Therapist 225XP0200X 004989 NY Primary

Addresses

Primary practice location

39 Molyneaux Rd
Valley Stream, NY 11580-1925

Mailing address

39 Molyneaux Rd
Valley Stream, NY 11580-1925
Phone (516) 561-9522

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111020000750 NY Practitioner - Occupational Therapist in Private Practice 8820260698 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
004989NYMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Outreach Physical and Occupational Therapy & Speech Rehabilitation, PLLC Physical Rehabilitation CurrentSince Sep 13, 2011 Accepting new patients

Locations

3 Grace Ave
Ste 119
Great Neck, NY 11021
Phone (212) 842-0080

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1225497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225497600000",
    "number": "1710130869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 MOLYNEAUX RD",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115801925",
            "telephone_number": "516-561-9522",
            "fax_number": "516-561-9522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 MOLYNEAUX RD",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115801925",
            "telephone_number": "516-561-9522",
            "fax_number": "516-561-9522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORSAINVIL",
        "first_name": "SUZIE",
        "name_prefix": "Mrs.",
        "credential": "OCCUP. THERAPIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-11-01",
        "last_updated": "2008-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XG0600X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Gerontology",
            "state": "NY",
            "license": "004989",
            "primary": false
        },
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "NY",
            "license": "004989",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NY",
            "license": "004989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley Stream, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2008; 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.