Individual provider Active NPI

Kristina Marie Whitbeck, MS OTR/L

  • Occupational Therapist
  • Canandaigua, NY
National Provider Identifier
1972702207
Registry record updated Jan 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
018362 Issued in NY
Practice address
5415 County Road 30
Canandaigua, NY 14424-7964
Phone
(585) 394-9510
NPI assigned
Jul 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2014

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 018362 NY Primary

Addresses

Primary practice location

5415 County Road 30
Canandaigua, NY 14424-7964

Mailing address

5415 County Road 30
Canandaigua, NY 14424-7964
Phone (585) 394-9510

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140219002064 NY Practitioner - Occupational Therapist in Private Practice 9234369133 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Finger Lakes United Cerebral Palsy, Inc.Group PAC ID 0446309660, 17 clinicians

Practice addresses (Care Compare)

5415 County Rd
Suite 30
Canandaigua, NY 14424-7964
Phone (585) 394-9510

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
018362NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Finger Lakes United Cerebral Palsy, Inc. CurrentSince Jan 7, 2014 Accepting new patients

Locations

5415 N Bloomfield Rd
Canandaigua, NY 14424
Phone (585) 394-1190

2975 County Road 48
Canandaigua, NY 14424
Phone (585) 396-3060

1065 Lochland Rd
Geneva, NY 14456
Phone (315) 789-5208

731 Pre Emption Rd
Geneva, NY 14456
Phone (315) 789-6828

Organizations & group practices 1

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": "1184630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389657600000",
    "number": "1972702207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5415 COUNTY ROAD 30",
            "city": "CANANDAIGUA",
            "state": "NY",
            "postal_code": "144247964",
            "telephone_number": "585-394-9510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5415 COUNTY ROAD 30",
            "city": "CANANDAIGUA",
            "state": "NY",
            "postal_code": "144247964",
            "telephone_number": "585-394-9510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITBECK",
        "first_name": "KRISTINA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "MS OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-17",
        "last_updated": "2014-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "018362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canandaigua, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.