Individual provider Active NPI

Lokeisha Y Tabannah, OTR/L

  • Occupational Therapy Assistant
  • Roosevelt, NY
National Provider Identifier
1902137243
Registry record updated May 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
006525 Issued in NY
Practice address
380 Washington Ave
Roosevelt, NY 11575-1845
Phone
(516) 378-2000
NPI assigned
Jan 27, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 1, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT26011 FL
Occupational Therapy Assistant 224Z00000X 006525 NY Primary

Addresses

Primary practice location

380 Washington Ave
Roosevelt, NY 11575-1845

Mailing address

9461 Brandywine LN
Port Saint Lucie, FL 34986-3307
Phone (772) 429-3600

Other names 1

  • Lokeisha Y Taylor Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250829001089 FL Practitioner - Occupational Therapist in Private Practice 2062913106 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
One Faith Therapy Inc.Group PAC ID 8628579844, 5 clinicians

Practice addresses (Care Compare)

240 NW Peacock Blvd
Suite 104
Port Saint Lucie, FL 34986-2274
Phone (561) 344-8254

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT26011FLMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
One Faith Therapy Inc. CurrentSince Aug 7, 2025 Accepting new patients

Locations

240 NW Peacock Blvd
Ste 104
Port Saint Lucie, FL 34986
Phone (561) 344-8254

1809 SE Port St Lucie Blvd
Port St Lucie, FL 34952
Phone (561) 344-8254

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": "1264550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746057600000",
    "number": "1902137243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9461 BRANDYWINE LN",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349863307",
            "telephone_number": "772-429-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 WASHINGTON AVE",
            "city": "ROOSEVELT",
            "state": "NY",
            "postal_code": "115751845",
            "telephone_number": "516-378-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TABANNAH",
        "first_name": "LOKEISHA",
        "middle_name": "Y",
        "name_prefix": "Ms.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-27",
        "last_updated": "2025-05-01",
        "certification_date": "2025-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT26011",
            "primary": false
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NY",
            "license": "006525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LOKEISHA",
            "last_name": "TAYLOR",
            "middle_name": "Y",
            "credential": "COTA/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Roosevelt, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2025; 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.