Nicole Burress, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

023313-1 Issued in NY

Practice address

475 Northern Blvd Ste 19
Great Neck, NY 11021-4802

Phone

(516) 829-0030

Fax

(516) 466-7723

NPI assigned

Jul 19, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Reddy Care Physical Therapy PC

  • Specialist
  • Great Neck, NY
  • NPI 1932171097
  NPD (past)

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

{
    "created_epoch": "1563494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579219200000",
    "number": "1891348884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 NORTHERN BLVD STE 27",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110214802",
            "telephone_number": "516-829-0030",
            "fax_number": "516-466-7723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 NORTHERN BLVD STE 19",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110214802",
            "telephone_number": "516-829-0030",
            "fax_number": "516-466-7723"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4345 Kelly Ave",
            "address_purpose": "LOCATION",
            "city": "Upper Chichester",
            "state": "PA",
            "postal_code": "190612613",
            "country_code": "US",
            "telephone_number": "610-331-0269",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURRESS",
        "first_name": "NICOLE",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-19",
        "last_updated": "2020-01-17",
        "certification_date": "2020-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "023313-1",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "PA",
            "license": "OC015468",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gary Bruschi, PH.D.
• BSD Plastic Surgical Suites, Inc
• Stephanie C Buck-Haskin, M.D.
• Alexandra Lillian Burdo, OTR/L
• Caitlin Brigid Burke, DPT
• Leslie S Burstein
• Burt M Greenberg MD PC
• Jennifer Busch, FNP-BC
• Ryan Alexander Buswell, MS, CCC-SLP
• Elena Byrne-Dirico, MSED, NCSP

• Occupational Therapist in Great Neck, NY
• Providers in Great Neck, NY by specialty
• Occupational Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2020; 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.