Active NPI
Josephine Prerovsky, OT
- Occupational Therapist
- Santa Fe, NM
National Provider Identifier
1902930928
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 1612
- Practice address
- 1300 Camino Sierra Vis
129
Santa Fe, NM 87505-1007 - Phone
- (505) 467-2504
- Fax
- (505) 467-2646
- NPI assigned
- Mar 14, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 1612 | NM | Primary |
Addresses
Primary practice location
1300 Camino Sierra Vis
129
Santa Fe, NM 87505-1007
Mailing address
820 Calle Torreador
Santa Fe, NM 87505-2668
Phone (505) 570-0962
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 17927005 | Medicaid | NM |
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 |
|---|---|---|---|
| 1612 | NM | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Santa Fe Public Schools | 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.
-
- Occupational Therapist
- Santa Fe, NM
- NPI 1902933500
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1902930928",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "820 CALLE TORREADOR",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875052668",
"telephone_number": "505-570-0962"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1300 CAMINO SIERRA VIS",
"address_2": "129",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875051007",
"telephone_number": "505-467-2504",
"fax_number": "505-467-2646"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PREROVSKY",
"first_name": "JOSEPHINE",
"name_prefix": "Ms.",
"credential": "OT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NM",
"license": "1612",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "17927005",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Santa Fe, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.