Individual provider Active NPI

Caridad Simon, OTR/L

  • Occupational Therapist
  • Jamaica, NY
National Provider Identifier
1851666119
Registry record updated Mar 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
011212-1 Issued in NY
Practice address
10959 Inwood St
Jamaica, NY 11435-5625
Phone
(718) 526-5523
Fax
(718) 526-8191
NPI assigned
Mar 19, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 19, 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 011212-1 NY Primary

Addresses

Primary practice location

10959 Inwood St
Jamaica, NY 11435-5625

Mailing address

20615 100TH Ave
Queens Village, NY 11429-1016
Phone (718) 465-6248

Other identifiers 1

IdentifierTypeStateIssuer
1289432MedicaidNY

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

State licenses

LicenseStateTypeSpecialty
011212-1NYMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1332115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332115200000",
    "number": "1851666119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20615 100TH AVE",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114291016",
            "telephone_number": "718-465-6248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10959 INWOOD ST",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114355625",
            "telephone_number": "718-526-5523",
            "fax_number": "718-526-8191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "CARIDAD",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-19",
        "last_updated": "2012-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "011212-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1289432",
            "state": "NY"
        }
    ],
    "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 Mar 19, 2012; 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.