Individual provider Active NPI

Samantha Ali Randazzo, COTA/L

  • Occupational Therapy Assistant
  • Yonkers, NY
National Provider Identifier
1972228252
Registry record updated Oct 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
011187-01 Issued in NY
Practice address
127 S Broadway
Yonkers, NY 10701-4006
Phone
(914) 378-7000
NPI assigned
Oct 10, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 011187-01 NY Primary

Addresses

Primary practice location

127 S Broadway
Yonkers, NY 10701-4006

Mailing address

246 Mulberry Rd
Ramsey, NJ 07446-1164
Phone (845) 558-1968

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

LicenseStateTypeSpecialty
011187-01NYMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1665360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665360000000",
    "number": "1972228252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "246 MULBERRY RD",
            "city": "RAMSEY",
            "state": "NJ",
            "postal_code": "074461164",
            "telephone_number": "845-558-1968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 S BROADWAY",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107014006",
            "telephone_number": "914-378-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDAZZO",
        "first_name": "SAMANTHA",
        "middle_name": "ALI",
        "credential": "COTA/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-10",
        "last_updated": "2022-10-10",
        "certification_date": "2022-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NY",
            "license": "011187-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yonkers, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2022; 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.