Active NPI
Susan Brabant, OTR
- Occupational Therapist
- North Massapequa, NY
National Provider Identifier
1720419476
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 63018509
- Practice address
- 188 North Delaware Avenue
North Massapequa, NY 11758 - Phone
- (516) 659-6707
- NPI assigned
- Dec 6, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 63018509 | NY | Primary |
| Massage Therapist | 225700000X | 007808 | NY |
Addresses
Primary practice location
188 North Delaware Avenue
North Massapequa, NY 11758
Mailing address
188 North Delaware Avenue
North Massapequa, NY 11758
Phone (516) 659-6707
Other names 1
- Dr. Susan M Brabant
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150826000211 | NY | Practitioner - Occupational Therapist in Private Practice | 5698081396 | Practice locations: N Massapequa, NY |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 007808 | NY | MD | Mental Health Counselor |
| 63018509 | NY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1386288000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1616457600000",
"number": "1720419476",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "188 NORTH DELAWARE AVENUE",
"city": "NORTH MASSAPEQUA",
"state": "NY",
"postal_code": "11758",
"telephone_number": "516-659-6707"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "188 NORTH DELAWARE AVENUE",
"city": "NORTH MASSAPEQUA",
"state": "NY",
"postal_code": "11758",
"telephone_number": "516-659-6707"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRABANT",
"first_name": "SUSAN",
"credential": "OTR",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-12-06",
"last_updated": "2021-03-23",
"certification_date": "2021-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "63018509",
"primary": true
},
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "NY",
"license": "007808",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "SUSAN",
"last_name": "BRABANT",
"middle_name": "M",
"prefix": "DR.",
"credential": "MASSAGE THERAPY",
"code": "2",
"type": "Professional Name"
}
]
}
Other providers in North Massapequa, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2021; 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.