Individual provider Active NPI

Lesley Samulak, OTD, OTR/L

  • Occupational Therapist
  • Bradenton, FL
National Provider Identifier
1831862804
Registry record updated Feb 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Practice address
1850 Rye Rd
Bradenton, FL 34212-9038
Phone
(941) 777-0527
Fax
(941) 315-8546
NPI assigned
Jul 27, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2024

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 Primary

Addresses

Primary practice location

1850 Rye Rd
Bradenton, FL 34212-9038

Mailing address

5775 Nannyberry Cir
Sarasota, FL 34238-5169
Phone (941) 777-0527

Other practice location 1

5775 Nannyberry Cir
Sarasota, FL 34238-5169
Phone (941) 777-0527

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211213000241 FL Practitioner - Occupational Therapist in Private Practice 8123418878 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5775 Nannyberry Cir
Sarasota, FL 34238-5169
Phone (941) 777-0527

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Optimal Performance and Physical Therapies-Brandon LLC CurrentSince Nov 23, 2021 Accepting new patients
Functional Interventions Therapy, P.a. Occupational Therapist CurrentSince Oct 12, 2022 Accepting new patients
JH Therapy Services Occupational Therapist CurrentSince Aug 3, 2024 Accepting new patients
JH Therapy Services CurrentSince Aug 3, 2024 Accepting new patients

Locations

1850 Rye Rd
Bradenton, FL 34212
Phone (941) 749-8552

1076 E Brandon Blvd
Ste 106
Brandon, FL 33511
Phone (813) 413-5513

611 W Lumsden Rd
Brandon, FL 33511
Phone (813) 413-5513

21756 State Road 54
Ste 102
Lutz, FL 33549
Phone (813) 279-6234

7157 Curtiss Ave
Sarasota, FL 34231
Phone (941) 924-5679

228 Park Ave S
New York, NY 10003
Phone (215) 588-2144

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1627344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707264000000",
    "number": "1831862804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5775 NANNYBERRY CIR",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342385169",
            "telephone_number": "941-777-0527",
            "fax_number": "941-315-8546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 RYE RD",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342129038",
            "telephone_number": "941-777-0527",
            "fax_number": "941-315-8546"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5775 Nannyberry Cir",
            "address_purpose": "LOCATION",
            "city": "Sarasota",
            "state": "FL",
            "postal_code": "342385169",
            "country_code": "US",
            "telephone_number": "941-777-0527",
            "fax_number": "941-315-8546",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAMULAK",
        "first_name": "LESLEY",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-27",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.