Individual provider Active NPI

Vanessa Catherine Kruger, OTR/L

  • Pediatric Occupational Therapist
  • New York, NY
National Provider Identifier
1881902484
Registry record updated Feb 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
016079-1 Issued in NY
Practice address
361 E 19TH St Ste 5
New York, NY 10003-2888
Phone
(212) 721-5220
NPI assigned
Sep 16, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 123338 TX
Pediatric Occupational Therapist 225XP0200X 016079-1 NY Primary

Addresses

Primary practice location

361 E 19TH St Ste 5
New York, NY 10003-2888

Mailing address

PO Box 1826
McKinney, TX 75070-8160
Phone (646) 420-0177

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
016079-1NYMDPediatric Occupational Therapist
123338TXMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Wild & Free OT PLLC Pediatrics CurrentSince Mar 5, 2023 Accepting new patients

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": "1284595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676246400000",
    "number": "1881902484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1826",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750708160",
            "telephone_number": "646-420-0177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "361 E 19TH ST STE 5",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100032888",
            "telephone_number": "212-721-5220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUGER",
        "first_name": "VANESSA",
        "middle_name": "CATHERINE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-16",
        "last_updated": "2023-02-13",
        "certification_date": "2023-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "TX",
            "license": "123338",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NY",
            "license": "016079-1",
            "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 Feb 13, 2023; 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.