Individual provider Active NPI

Takako Nishiyama, OT

  • Occupational Therapist
  • Hartsdale, NY
National Provider Identifier
1841562279
Registry record updated Feb 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
009245 Issued in NY
Practice address
80 Pinewood Rd
Apt #2B
Hartsdale, NY 10530-1672
Phone
(646) 247-7340
NPI assigned
Feb 1, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 1, 2012

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 009245 NY Primary

Addresses

Primary practice location

80 Pinewood Rd
Apt #2B
Hartsdale, NY 10530-1672

Mailing address

80 Pinewood Rd
Apt #2B
Hartsdale, NY 10530-1672
Phone (646) 247-7340

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170117000526 NY Practitioner - Occupational Therapist in Private Practice 2264714807 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Union Community Health Center, Inc. CurrentSince Dec 7, 2016 Accepting new patients

Locations

4487 3rd Ave
Fl 7
Bronx, NY 10457
Phone (718) 960-6173

260 E 188th St
Bronx, NY 10458
Phone (718) 618-8236

4487 3rd Ave
Bronx, NY 10457
Phone (718) 960-3730

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

Organizations & group practices 1

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": "1328054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328054400000",
    "number": "1841562279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 PINEWOOD RD",
            "address_2": "APT #2B",
            "city": "HARTSDALE",
            "state": "NY",
            "postal_code": "105301672",
            "telephone_number": "646-247-7340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 PINEWOOD RD",
            "address_2": "APT #2B",
            "city": "HARTSDALE",
            "state": "NY",
            "postal_code": "105301672",
            "telephone_number": "646-247-7340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NISHIYAMA",
        "first_name": "TAKAKO",
        "credential": "OT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-02-01",
        "last_updated": "2012-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "009245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartsdale, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2012; 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.