Individual provider Active NPI

Rose Ester Nowack, OTR/L

  • Pediatric Occupational Therapist
  • Bronx, NY
National Provider Identifier
1871867838
Registry record updated Mar 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
013854-1 Issued in NY
Practice address
40 W Tremont Ave
Bronx, NY 10453-5400
Phone
(718) 583-5355
NPI assigned
Mar 8, 2012
Last updated
Mar 8, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 8, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 013854-1 NY Primary

Addresses

Primary practice location

40 W Tremont Ave
Bronx, NY 10453-5400

Mailing address

6 Fairfield Rd
Yonkers, NY 10705-1707

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151001000972 NY Practitioner - Occupational Therapist in Private Practice 2062720675 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
013854NYMDPediatric Physical Therapist
013854-1NYMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Epic Medical Services PC CurrentSince Apr 1, 2016 Accepting new patients
Lifespire, Inc. CurrentSince Sep 1, 2015 Accepting new patients
Epic Long Island CurrentSince Aug 5, 2015 Accepting new patients
Epilepsy Foundation of L.I. CurrentSince Aug 5, 2015 Accepting new patients
Lifespire, Inc. CurrentSince Sep 1, 2015 Accepting new patients
Global SLP OT PT & Psychological Services, PLLC CurrentSince Jan 1, 2021 Accepting new patients

Locations

21301 Northern Blvd
Fl 2
Bayside, NY 11361
Phone (718) 721-5444

1500 Hempstead Tpke
East Meadow, NY 11554
Phone 51673977331420

1979 Marcus Ave
Ste 204
New Hyde Park, NY 11042
Phone (516) 327-4681

159 E 125th St
Fl 2
New York, NY 10035
Phone (212) 360-5600

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1331164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331164800000",
    "number": "1871867838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 FAIRFIELD RD",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107051707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 W TREMONT AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104535400",
            "telephone_number": "718-583-5355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOWACK",
        "first_name": "ROSE",
        "middle_name": "ESTER",
        "name_prefix": "Ms.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-08",
        "last_updated": "2012-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NY",
            "license": "013854-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.