Individual provider Active NPI

Daniela Gordillo, MOTR/L

  • Occupational Therapist
  • Bronx, NY
National Provider Identifier
1952890188
Registry record updated Jul 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Practice address
1055 E Tremont Ave
Bronx, NY 10460-2306
Phone
(929) 385-4299
Fax
(646) 395-3823
NPI assigned
May 3, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2023

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 Primary

Addresses

Primary practice location

1055 E Tremont Ave
Bronx, NY 10460-2306

Mailing address

1109 Adee Ave FL 1
Bronx, NY 10469-5117
Phone (929) 385-4299

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210130000262 NY Practitioner - Occupational Therapist in Private Practice 6002220233 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Balanced Occupational Therapy PC Occupational Therapist Current Accepting new patients
Montefiore Medical Center CurrentSince Oct 1, 2021 Accepting new patients
Montefiore Medical Center CurrentSince Oct 1, 2021 Accepting new patients

Locations

1250 Waters Pl
Ste 501
Bronx, NY 10461
Phone (718) 319-1740

111 E 210th St
Bronx, NY 10467

1055 E Tremont Ave
Bronx, NY 10460
Phone (718) 842-8040

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 3

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": "1525305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689120000000",
    "number": "1952890188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1109 ADEE AVE FL 1",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104695117",
            "telephone_number": "929-385-4299",
            "fax_number": "646-395-3823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 E TREMONT AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104602306",
            "telephone_number": "929-385-4299",
            "fax_number": "646-395-3823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDILLO",
        "first_name": "DANIELA",
        "credential": "MOTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-03",
        "last_updated": "2023-07-12",
        "certification_date": "2023-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2023; 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.