NPIMap

Individual provider Active NPI

Michael Carbone, OTR/L

  • Occupational Therapist
  • Stratford, CT
National Provider Identifier
1760949465
Registry record updated Feb 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5093 Issued in CT
Practice address
999 Oronoque LN
Stratford, CT 06614-1379
Phone
(203) 870-2022
NPI assigned
Feb 28, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT01758 RI
Occupational Therapist 225X00000X 5093 CT Primary

Addresses

Primary practice location

999 Oronoque LN
Stratford, CT 06614-1379

Mailing address

999 Oronoque LN
Stratford, CT 06614-1379

Other practice location 1

129 Main St
Old Saybrook, CT 06475-2377
Phone (203) 521-0603

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
OT01758RIMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1551312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551312000000",
    "number": "1760949465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "999 ORONOQUE LN",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066141379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "999 ORONOQUE LN",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066141379",
            "telephone_number": "203-870-2022"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "129 Main St",
            "address_purpose": "LOCATION",
            "city": "Old Saybrook",
            "state": "CT",
            "postal_code": "064752377",
            "country_code": "US",
            "telephone_number": "203-521-0603",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARBONE",
        "first_name": "MICHAEL",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-28",
        "last_updated": "2019-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "RI",
            "license": "OT01758",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CT",
            "license": "5093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stratford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 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.