Individual provider Active NPI

Kristen Cuccoli, OTR/L

  • Pediatric Occupational Therapist
  • Newton, MA
National Provider Identifier
1881491124
Registry record updated Feb 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
OTL14346 Issued in MA
Practice address
74 Bridge St
Newton, MA 02458-1147
Phone
(617) 969-4410
NPI assigned
Feb 25, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2025

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 OTL14346 MA Primary

Addresses

Primary practice location

74 Bridge St
Newton, MA 02458-1147

Mailing address

90 Parker St
Westwood, MA 02090-1215
Phone (781) 375-7286

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
OTL14346MAMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ota the Koomar Center, LLC Pediatrics CurrentSince Mar 11, 2025 Accepting new patients
Occupational Therapy Associates - Watertown, Inc. CurrentSince Mar 11, 2025 Accepting new patients

Locations

74 Bridge St
Newton, MA 02458
Phone (617) 969-4410

Organizations & group practices 2

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": "1740441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1881491124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 PARKER ST",
            "city": "WESTWOOD",
            "state": "MA",
            "postal_code": "020901215",
            "telephone_number": "781-375-7286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74 BRIDGE ST",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024581147",
            "telephone_number": "617-969-4410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUCCOLI",
        "first_name": "KRISTEN",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-02-25",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "MA",
            "license": "OTL14346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2025; 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.