Individual provider Active NPI

Taryn Johrden, OTR/L

  • Occupational Therapist
  • Brooklyn, NY
National Provider Identifier
1922694348
Registry record updated Dec 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
025061 Issued in NY
Practice address
2579 Ocean Ave FL 3
Brooklyn, NY 11229-4552
Phone
(646) 780-0926
NPI assigned
Dec 20, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 025061 NY Primary

Addresses

Primary practice location

2579 Ocean Ave FL 3
Brooklyn, NY 11229-4552

Mailing address

904 Viceroy Rd
Wantagh, NY 11793-1653
Phone (516) 297-8924

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210113001282 NY Practitioner - Occupational Therapist in Private Practice 2567875487 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sports Physical Therapy Occupational Therapy and Rehabilitation Servic Occupational Therapist CurrentSince Mar 1, 2025 Accepting new patients
Sports Physical Therapy Occupational Therapy and Rehabilitation Servic Occupational Therapist CurrentSince Mar 1, 2025 Accepting new patients

Locations

801 Merrick Ave
East Meadow, NY 11554
Phone (516) 393-8900

9525 Queens Blvd
Ste 3D
Rego Park, NY 11374
Phone (718) 925-6212

972 Brush Hollow Rd
Fl 4
Westbury, NY 11590
Phone (516) 321-7526

Organizations & group practices 2

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": "1608422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608422400000",
    "number": "1922694348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 VICEROY RD",
            "city": "WANTAGH",
            "state": "NY",
            "postal_code": "117931653",
            "telephone_number": "516-297-8924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2579 OCEAN AVE FL 3",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112294552",
            "telephone_number": "646-780-0926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHRDEN",
        "first_name": "TARYN",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-20",
        "last_updated": "2020-12-20",
        "certification_date": "2020-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "025061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2020; 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.