Individual provider Active NPI

Nancy Caracciolo, OTR/L

  • Occupational Therapist
  • Brooklyn, NY
National Provider Identifier
1871078105
Registry record updated Apr 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
0207951 Issued in NY
Practice address
4013 Avenue U BLDG Suite
Brooklyn, NY 11234-5117
Phone
(718) 692-4100
NPI assigned
Oct 2, 2018
Last updated
Apr 19, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 19, 2021

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 0207951 NY Primary

Addresses

Primary practice location

4013 Avenue U BLDG Suite
Brooklyn, NY 11234-5117

Mailing address

475 Park Ave S
New York, NY 10016-6901
Phone (212) 683-1988

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
020795NYMDPsychologist
0207951NYMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1538438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618790400000",
    "number": "1871078105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 PARK AVE S",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166901",
            "telephone_number": "212-683-1988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4013 AVENUE U BLDG SUITE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112345117",
            "telephone_number": "718-692-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARACCIOLO",
        "first_name": "NANCY",
        "name_prefix": "Ms.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-02",
        "last_updated": "2021-04-19",
        "certification_date": "2021-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "0207951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2021; 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.