NPIMap

Organization Active NPI

Origin Occupational & Physical Therapy PLLC

  • Occupational Therapist
  • Brooklyn, NY
National Provider Identifier
1790062164
Registry record updated Nov 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
004893 Issued in NY
Legal business name
ORIGIN OCCUPATIONAL & PHYSICAL THERAPY PLLC
Practice address
1220 E New York Ave
Brooklyn, NY 11212-3832
Phone
(718) 221-0010
NPI assigned
Nov 13, 2011
Last updated
Nov 13, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2011

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

Authorized official

Name
Marcel Picard, OTRNPI 1851602379
Title
President
Phone
(516) 581-9387

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 029330 NY
Occupational Therapist 225X00000X 004893 NY Primary

Addresses

Primary practice location

1220 E New York Ave
Brooklyn, NY 11212-3832

Mailing address

681 Janos LN
W Hempstead, NY 11552-4162

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111228000430 NY Part B Supplier - Clinic/Group Practice 3779759550 Receives reassigned benefits from 5 practitioners
Practice locations: Brooklyn, NY; Jamaica, NY

National Provider Directory

National Provider Directory

Locations

1220 E New York Ave
Brooklyn, NY 11212
Phone (718) 221-0010

5202 Avenue N
Brooklyn, NY 11234
Phone (718) 208-4433

5606 Avenue N
Brooklyn, NY 11234
Phone (718) 676-0583

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1321142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321142400000",
    "number": "1790062164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "681 JANOS LN",
            "city": "W HEMPSTEAD",
            "state": "NY",
            "postal_code": "115524162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 E NEW YORK AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112123832",
            "telephone_number": "718-221-0010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORIGIN OCCUPATIONAL & PHYSICAL THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-13",
        "last_updated": "2011-11-13",
        "status": "A",
        "authorized_official_last_name": "PICARD",
        "authorized_official_first_name": "MARCEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-581-9387",
        "authorized_official_credential": "OTR"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "029330",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "004893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 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.