Individual provider Active NPI

Rosa Balouka, OTA

  • Occupational Therapy Assistant
  • Highland Mills, NY
National Provider Identifier
1720369770
Registry record updated Sep 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
007928 Issued in NY
Practice address
615 State Route 32
Highland Mills, NY 10930-5200
Phone
(845) 827-5360
Fax
(845) 827-5361
NPI assigned
Sep 5, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2011

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 007928 NY Primary

Addresses

Primary practice location

615 State Route 32
Highland Mills, NY 10930-5200

Mailing address

PO Box 25
Highland Mills, NY 10930-0025
Phone (845) 827-5360

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric OT Solutions 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1315180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315180800000",
    "number": "1720369770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25",
            "city": "HIGHLAND MILLS",
            "state": "NY",
            "postal_code": "109300025",
            "telephone_number": "845-827-5360",
            "fax_number": "845-827-5361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 STATE ROUTE 32",
            "city": "HIGHLAND MILLS",
            "state": "NY",
            "postal_code": "109305200",
            "telephone_number": "845-827-5360",
            "fax_number": "845-827-5361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALOUKA",
        "first_name": "ROSA",
        "credential": "OTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-05",
        "last_updated": "2011-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NY",
            "license": "007928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Highland Mills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2011; 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.