Nicole Derobertis, DPT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

026210 Issued in NY

Practice address

80 Route 6 Unit 701702
Baldwin Place, NY 10505-1026

Phone

(845) 875-0500

NPI assigned

Feb 6, 2023

Last updated

Feb 6, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Pathology, PLLC

  dba IvyRehab for Kids

  • Early Intervention Provider Agency
  • Baldwin Place, NY
  • NPI 1528749496
  NPD

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

{
    "created_epoch": "1675641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675641600000",
    "number": "1922704378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 MAMARONECK AVE STE 140",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106055224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 ROUTE 6 UNIT 701702",
            "city": "BALDWIN PLACE",
            "state": "NY",
            "postal_code": "105051026",
            "telephone_number": "845-875-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEROBERTIS",
        "first_name": "NICOLE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-06",
        "last_updated": "2023-02-06",
        "certification_date": "2023-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "026210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Theresa Butti
• Catherine Marie Cain, DPT
• Andrea Carmina Eisley, PHARMD
• Jenny Marie Fadda, RD, CDN, CNSC
• Alexis Hannah Goldstein
• Diana Mary Innocent, PT, DPT
• Ivyrehab Physical Therapy, Occupational Therapy & Speech Language Pathology, PLLC (IvyRehab for Kids)

• Occupational Therapist in Baldwin Place, NY
• Providers in Baldwin Place, 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 Feb 6, 2023; 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.