Individual provider Active NPI

Samana Khan, OTR/L

  • Occupational Therapist
  • Old Westbury, NY
National Provider Identifier
1851658884
Registry record updated Dec 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
017239-1 Issued in NY
Practice address
Northern Boulevard
Nyit College of Osteopathic Medicine
Old Westbury, NY 11568
Phone
(631) 686-1279
NPI assigned
Apr 16, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 9571 CA
Occupational Therapist 225X00000X 017239-1 NY Primary

Addresses

Primary practice location

Northern Boulevard
Nyit College of Osteopathic Medicine
Old Westbury, NY 11568

Mailing address

73 E 23Rd St
Huntington Station, NY 11746-3214
Phone (408) 504-2331

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
017239-1NYMDOccupational Therapist
9571CAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1334534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418860800000",
    "number": "1851658884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "73 E 23RD ST",
            "city": "HUNTINGTON STATION",
            "state": "NY",
            "postal_code": "117463214",
            "telephone_number": "408-504-2331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NORTHERN BOULEVARD",
            "address_2": "NYIT COLLEGE OF OSTEOPATHIC MEDICINE",
            "city": "OLD WESTBURY",
            "state": "NY",
            "postal_code": "11568",
            "telephone_number": "631-686-1279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "SAMANA",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-16",
        "last_updated": "2014-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "9571",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "017239-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Old Westbury, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.