Courtney Prada, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

021002 Issued in NY

Practice address

17 Harrison Ave
Bellport, NY 11713-1115

Phone

(631) 902-9759

NPI assigned

Oct 26, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY, DC, VA3 enrollments

Enrollment records 3

Specialty

Occupational Therapist in Private Practice

Education

Other, 2016

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Fox Rehabilitation Physical Therapy Services LLC

  • Physical Therapist
  • New York, NY
  • NPI 1174560650

  Occupational Therapist

  Medicare reassignment NPD
• Fox Rehabilitation Services LLC

  • Physical Therapist
  • Winchester, VA
  • NPI 1609814755

  DC, Occupational Therapist

  Medicare reassignment NPD

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

{
    "created_epoch": "1477440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477440000000",
    "number": "1851843791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 HARRISON AVE",
            "city": "BELLPORT",
            "state": "NY",
            "postal_code": "117131115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 HARRISON AVE",
            "city": "BELLPORT",
            "state": "NY",
            "postal_code": "117131115",
            "telephone_number": "631-902-9759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRADA",
        "first_name": "COURTNEY",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-26",
        "last_updated": "2016-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "021002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bettina Pennon, CASAC
• Jessica Pentecost
• Sarah Perrino
• Yolette Pierre
• Kim Denise Potter, LPN
• Professional Corporation
• QK Healthcare, Inc.
• Quality King Distributors, Inc.
• Emily Paige Reich, RDN
• Michael Rene, LMSW

• Occupational Therapist in Bellport, NY
• Providers in Bellport, NY by specialty
• Occupational Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2016; 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.