NPIMap

Organization Active NPI

Home Advantage Occupational Therapy, P.C.

  • Specialist
  • Bellmore, NY
National Provider Identifier
1730467572
Registry record updated Jul 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
010005 Issued in NY
Legal business name
HOME ADVANTAGE OCCUPATIONAL THERAPY, P.C.
Practice address
2721 Lee PL
Bellmore, NY 11710-5003
Phone
(516) 729-4834
Fax
(516) 706-2182
NPI assigned
Jul 27, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2011

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

Authorized official

Name
Mr. Michael John Marzano, OTR/LNPI 1841382405
Title
President
Phone
(516) 729-4834

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 010005 NY Primary

Addresses

Primary practice location

2721 Lee PL
Bellmore, NY 11710-5003

Mailing address

2721 Lee PL
Bellmore, NY 11710-5003
Phone (516) 729-4834

Other identifiers 2

IdentifierTypeStateIssuer
02584632MedicaidNY
A300000511OtherNYMEDICARE PTAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111205000611 NY Part B Supplier - Clinic/Group Practice 4385819218 Receives reassigned benefits from 20 practitioners
Practice locations: Medford, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 21

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1311724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311724800000",
    "number": "1730467572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2721 LEE PL",
            "city": "BELLMORE",
            "state": "NY",
            "postal_code": "117105003",
            "telephone_number": "516-729-4834",
            "fax_number": "516-706-2182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2721 LEE PL",
            "city": "BELLMORE",
            "state": "NY",
            "postal_code": "117105003",
            "telephone_number": "516-729-4834",
            "fax_number": "516-706-2182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOME ADVANTAGE OCCUPATIONAL THERAPY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-27",
        "last_updated": "2011-07-27",
        "status": "A",
        "authorized_official_last_name": "MARZANO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-729-4834",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "010005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02584632",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "A300000511",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellmore, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2011; 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.