Individual provider Active NPI

Tawana Marcial

  • Occupational Therapist
  • Brooklyn, NY
National Provider Identifier
1831387398
Registry record updated Mar 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
011822-1 Issued in NY
Practice address
245 E 45TH St
Brooklyn, NY 11203-2112
Phone
(212) 221-1544
NPI assigned
Oct 10, 2007
Last updated
Mar 9, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 011822-1 NY Primary

Addresses

Primary practice location

245 E 45TH St
Brooklyn, NY 11203-2112

Mailing address

11949 223Rd St
Cambria Heights, NY 11411-2023
Phone (212) 221-1544

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071130000369 NY Practitioner - Occupational Therapist in Private Practice 3173612934 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
011822-1NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Young Adult Institute, Inc. CurrentSince Oct 5, 2019 Accepting new patients
Premier Healthcare, Inc. CurrentSince Dec 1, 2015 Accepting new patients
Premier Healthcare, Inc. CurrentSince Dec 1, 2015 Accepting new patients

Locations

21111 Northern Blvd
Bayside, NY 11361
Phone (212) 563-7474

21111 Northern Blvd
#13292
Bayside, NY 11361
Phone (718) 705-1000

3060 E Tremont Ave
Bronx, NY 10461
Phone (718) 239-1790

220 E 42nd St
Fl 8
New York, NY 10017
Phone (212) 273-2761

460 W 34th St
Fl 9
New York, NY 10001
Phone (212) 273-6515

Interoperability endpoints

  • Direct secure messaging: tawana.marcial.p1@direct.premierhealthcare.nextgenshare.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1191974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646784000000",
    "number": "1831387398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11949 223RD ST",
            "city": "CAMBRIA HEIGHTS",
            "state": "NY",
            "postal_code": "114112023",
            "telephone_number": "212-221-1544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 E 45TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032112",
            "telephone_number": "212-221-1544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCIAL",
        "first_name": "TAWANA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-10",
        "last_updated": "2022-03-09",
        "certification_date": "2022-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "011822-1",
            "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 Mar 9, 2022; 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.