Individual provider Active NPI

Gabrielle Sophia Leach

  • Occupational Therapist
  • New York, NY
National Provider Identifier
1871318626
Registry record updated Nov 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
029695-01 Issued in NY
Practice address
1110 2ND Ave RM 302
New York, NY 10022-2021
Phone
(212) 842-0080
Fax
(917) 591-8494
NPI assigned
Nov 18, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2024

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 029695-01 NY Primary

Addresses

Primary practice location

1110 2ND Ave RM 302
New York, NY 10022-2021

Mailing address

332 E 71St St Apt 5B
New York, NY 10021-5295
Phone (443) 771-0589

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241219001977 NY Practitioner - Occupational Therapist in Private Practice 5991232621 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

210 N Central Ave
Suite 330
Hartsdale, NY 10530-1951
Phone (914) 946-5685

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
029695-01NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sports Physical Therapy Occupational Therapy and Rehabilitation Servic Occupational Therapist CurrentSince Mar 1, 2025 Accepting new patients
Outreach Physical and Occupational Therapy & Speech Rehabilitation, PLLC CurrentSince Dec 2, 2024 Accepting new patients
Sports Physical Therapy Occupational Therapy and Rehabilitation Servic Occupational Therapist CurrentSince Mar 1, 2025 Accepting new patients

Locations

3 Grace Ave
Ste 119
Great Neck, NY 11021
Phone (212) 842-0080

210 N Central Ave
Ste 330
Hartsdale, NY 10530
Phone (914) 873-1878

2465 Broadway
Lowr
New York, NY 10025
Phone (212) 877-2525

54 Murray St
New York, NY 10007
Phone (212) 453-4622

1110 2nd Ave
Rm 302
New York, NY 10022
Phone (212) 842-0080

Organizations & group practices 3

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": "1731888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1871318626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "332 E 71ST ST APT 5B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100215295",
            "telephone_number": "443-771-0589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 2ND AVE RM 302",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100222021",
            "telephone_number": "212-842-0080",
            "fax_number": "917-591-8494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEACH",
        "first_name": "GABRIELLE",
        "middle_name": "SOPHIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-18",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "029695-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2024; 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.