Organization Active NPI

Professional Occupational & Physical Therapy, PLLC

  • Occupational Therapist
  • White Plains, NY
National Provider Identifier
1912457722
Registry record updated Mar 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Legal business name
PROFESSIONAL OCCUPATIONAL & PHYSICAL THERAPY, PLLC
Practice address
100 Main St
Unit 113a
White Plains, NY 10601-2601
Phone
(914) 948-3893
Fax
(914) 948-5276
NPI assigned
Oct 5, 2016
Last updated
Mar 29, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2018

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

Authorized official

Name
Kathleen Stratton
Title
Credentialing Coordinator Manager
Phone
(718) 819-6805

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU
Occupational Therapist 225X00000X NU Primary

Addresses

Primary practice location

100 Main St
Unit 113a
White Plains, NY 10601-2601

Mailing address

576 Broadhollow Rd
Melville, NY 11747-5002
Phone (718) 819-6805

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160608000715 NY Part B Supplier - Physical/Occupational Therapy Group in Private Practice 3779873401 Receives reassigned benefits from 513 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory

Locations

100 Main St
Unit 113A
White Plains, NY 10601
Phone (914) 948-3893

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1475625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522281600000",
    "number": "1912457722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "576 BROADHOLLOW RD",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117475002",
            "telephone_number": "718-819-6805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MAIN ST",
            "address_2": "UNIT 113A",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106012601",
            "telephone_number": "914-948-3893",
            "fax_number": "914-948-5276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL OCCUPATIONAL & PHYSICAL THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-05",
        "last_updated": "2018-03-29",
        "status": "A",
        "authorized_official_last_name": "STRATTON",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR MANAGER",
        "authorized_official_telephone_number": "718-819-6805"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in White Plains, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.