NPIMap

Organization Active NPI

SDK Physical and Occupational Therapy, PLLC

  • Occupational Therapist
  • New York, NY
National Provider Identifier
1740954544
Registry record updated Aug 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Legal business name
SDK PHYSICAL AND OCCUPATIONAL THERAPY, PLLC
Practice address
119 W 57TH St Ste 212
New York, NY 10019-2302
Phone
(212) 421-5505
Fax
(212) 421-1750
NPI assigned
Aug 4, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2021

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

Authorized official

Name
Stephanie Dessi Kiley, OTNPI 1588857809
Title
Member / OT
Phone
(917) 273-8225

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
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X Primary

Addresses

Primary practice location

119 W 57TH St Ste 212
New York, NY 10019-2302

Mailing address

233 Stamford Ave
Stamford, CT 06902-8202
Phone (917) 273-8225

Other practice location 1

1 Bank St Ste 207
Stamford, CT 06901-3006
Phone (917) 273-8225

Other names 1

  • Self Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CT2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20211216000300 NY Part B Supplier - Physical/Occupational Therapy Group in Private Practice 5395136964 Receives reassigned benefits from 7 practitioners
Practice locations: New York, NY
O20211216001653 CT Part B Supplier - Physical/Occupational Therapy Group in Private Practice 5395136964 Receives reassigned benefits from 2 practitioners
Practice locations: Stamford, CT

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

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

NPI Registry JSON

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

{
    "created_epoch": "1628035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628035200000",
    "number": "1740954544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "233 STAMFORD AVE",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069028202",
            "telephone_number": "917-273-8225",
            "fax_number": "212-421-1750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 W 57TH ST STE 212",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100192302",
            "telephone_number": "212-421-5505",
            "fax_number": "212-421-1750"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Bank St Ste 207",
            "address_purpose": "LOCATION",
            "city": "Stamford",
            "state": "CT",
            "postal_code": "069013006",
            "country_code": "US",
            "telephone_number": "917-273-8225",
            "fax_number": "212-421-1750",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SDK PHYSICAL AND OCCUPATIONAL THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-04",
        "last_updated": "2021-08-04",
        "certification_date": "2021-08-04",
        "status": "A",
        "authorized_official_last_name": "KILEY",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "DESSI",
        "authorized_official_title_or_position": "MEMBER / OT",
        "authorized_official_telephone_number": "917-273-8225",
        "authorized_official_credential": "OT"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Self",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 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.

Verify at the official NPI Registry.