Individual provider Active NPI

Rosa Maria Nieves, OTA

  • Occupational Therapy Assistant
  • Middle Village, NY
National Provider Identifier
1710525084
Registry record updated Dec 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
005453 Issued in NY
Practice address
6135 Dry Harbor Rd
Middle Village, NY 11379-1599
Phone
(718) 565-4262
NPI assigned
Dec 17, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 005453 NY Primary

Addresses

Primary practice location

6135 Dry Harbor Rd
Middle Village, NY 11379-1599

Mailing address

1810 Stockholm St Apt 2L
Ridgewood, NY 11385-1322
Phone (347) 255-6637

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

State licenses

LicenseStateTypeSpecialty
005453NYMDRegistered Respiratory Therapist

NPI Registry JSON

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

{
    "created_epoch": "1576540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576540800000",
    "number": "1710525084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1810 STOCKHOLM ST APT 2L",
            "city": "RIDGEWOOD",
            "state": "NY",
            "postal_code": "113851322",
            "telephone_number": "347-255-6637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6135 DRY HARBOR RD",
            "city": "MIDDLE VILLAGE",
            "state": "NY",
            "postal_code": "113791599",
            "telephone_number": "718-565-4262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEVES",
        "first_name": "ROSA",
        "middle_name": "MARIA",
        "credential": "OTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-17",
        "last_updated": "2019-12-17",
        "certification_date": "2019-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NY",
            "license": "005453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middle Village, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2019; 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.