Individual provider Active NPI

Nikita Shah, OTR/L

  • Occupational Therapist
  • Syosset, NY
National Provider Identifier
1861983405
Registry record updated Jan 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
022563 Issued in NY
Practice address
2 Hoagland Avenue
Syosset, NY 11791
Phone
(347) 282-9634
NPI assigned
May 18, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2025

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 022563 NY Primary

Addresses

Primary practice location

2 Hoagland Avenue
Syosset, NY 11791

Mailing address

2 Hoagland Avenue
Syosset, NY 11791
Phone (347) 282-9634

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201117002800 NY Practitioner - Occupational Therapist in Private Practice 9032520341 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Polaris Physical Therapy PLLCGroup PAC ID 0749677466, 3 clinicians

Practice addresses (Care Compare)

6529 Grand Ave
Maspeth, NY 11378-2422
Phone (718) 715-4871

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
022563NYMDClinical Social Worker

Networks

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

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": "1526601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737590400000",
    "number": "1861983405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 HOAGLAND AVENUE",
            "city": "SYOSSET",
            "state": "NY",
            "postal_code": "11791",
            "telephone_number": "347-282-9634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 HOAGLAND AVENUE",
            "city": "SYOSSET",
            "state": "NY",
            "postal_code": "11791",
            "telephone_number": "347-282-9634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "NIKITA",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-18",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "022563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syosset, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2025; 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.