Active NPI
Brycen Nicole Raybon, OTR/L
- Occupational Therapist
- New York, NY
National Provider Identifier
1891343398
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 023718
- Practice address
- 164 W 79TH St Apt 1C
New York, NY 10024-6440 - Phone
- (212) 712-2014
- NPI assigned
- Aug 28, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 120093 | TX | |
| Occupational Therapist | 225X00000X | 023718 | NY | Primary |
Addresses
Primary practice location
164 W 79TH St Apt 1C
New York, NY 10024-6440
Mailing address
1716 2ND Ave Apt 3F
New York, NY 10128-3520
Phone (972) 249-7503
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
| License | State | Type | Specialty |
|---|---|---|---|
| 023718 | NY | MD | Occupational Therapist |
| 120093 | TX | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Communikids Ny SLP & OT, PLLC | Occupational Therapist | Past | 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.
-
- Speech-Language Pathologist
- New York, NY
- NPI 1538418090
Occupational Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1566950400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1566950400000",
"number": "1891343398",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1716 2ND AVE APT 3F",
"city": "NEW YORK",
"state": "NY",
"postal_code": "101283520",
"telephone_number": "972-249-7503"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "164 W 79TH ST APT 1C",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100246440",
"telephone_number": "212-712-2014"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAYBON",
"first_name": "BRYCEN",
"middle_name": "NICOLE",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-08-28",
"last_updated": "2019-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Occupational Therapist",
"state": "TX",
"license": "120093",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Occupational Therapist",
"state": "NY",
"license": "023718",
"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 Aug 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.