Individual provider Active NPI

Ellyn Christen Gately, OTR/L

  • Occupational Therapist
  • Wading River, NY
National Provider Identifier
1891002259
Registry record updated Jul 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
007739 Issued in NY
Practice address
5 Salem CT
Wading River, NY 11792-2322
Phone
(631) 965-8992
NPI assigned
Sep 7, 2010
Last updated
Jul 2, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2016

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 007739 NY Primary

Addresses

Primary practice location

5 Salem CT
Wading River, NY 11792-2322

Mailing address

5 Salem CT
Wading River, NY 11792-2322
Phone (631) 965-8992

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121025000325 NY Practitioner - Occupational Therapist in Private Practice 5890945935 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Wading River, NY 11792
Phone (631) 965-8992

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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, 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": "1283817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467417600000",
    "number": "1891002259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 SALEM CT",
            "city": "WADING RIVER",
            "state": "NY",
            "postal_code": "117922322",
            "telephone_number": "631-965-8992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 SALEM CT",
            "city": "WADING RIVER",
            "state": "NY",
            "postal_code": "117922322",
            "telephone_number": "631-965-8992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GATELY",
        "first_name": "ELLYN",
        "middle_name": "CHRISTEN",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-07",
        "last_updated": "2016-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "007739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wading River, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2016; 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.