Active NPI
Breanna Prophete, MS, OTR/L
- Occupational Therapist
- Jamaica, NY
National Provider Identifier
1790460046
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 027922-01
- Practice address
- 8212 151St Ave
Jamaica, NY 11414-1793 - Phone
- (718) 848-0300
- NPI assigned
- Jun 15, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 027922-01 | NY | Primary |
Addresses
Primary practice location
8212 151St Ave
Jamaica, NY 11414-1793
Mailing address
10707 165TH St
Jamaica, NY 11433-2406
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 027922-01 | NY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1686787200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686787200000",
"number": "1790460046",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10707 165TH ST",
"city": "JAMAICA",
"state": "NY",
"postal_code": "114332406"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8212 151ST AVE",
"city": "JAMAICA",
"state": "NY",
"postal_code": "114141793",
"telephone_number": "718-848-0300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PROPHETE",
"first_name": "BREANNA",
"credential": "MS, OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-06-15",
"last_updated": "2023-06-15",
"certification_date": "2023-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "027922-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jamaica, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.