Active NPI
Prafulla Patil
- Occupational Therapist
- Stoneham, MA
National Provider Identifier
1982370722
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 10768
- Practice address
- 55 Katherine Rd
Stoneham, MA 02180-2749 - Phone
- (857) 352-7636
- NPI assigned
- Aug 20, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 10768 | MA | Primary |
Addresses
Primary practice location
55 Katherine Rd
Stoneham, MA 02180-2749
Mailing address
55 Katherine Rd
Stoneham, MA 02180-2749
Phone (857) 352-7636
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10768 | Other | MA | MA OT LICENSE NUMBER |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1629417600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629417600000",
"number": "1982370722",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "55 KATHERINE RD",
"city": "STONEHAM",
"state": "MA",
"postal_code": "021802749",
"telephone_number": "857-352-7636"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55 KATHERINE RD",
"city": "STONEHAM",
"state": "MA",
"postal_code": "021802749",
"telephone_number": "857-352-7636"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATIL",
"first_name": "PRAFULLA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-08-20",
"last_updated": "2021-08-20",
"certification_date": "2021-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MA",
"license": "10768",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MA OT LICENSE NUMBER",
"identifier": "10768",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Stoneham, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.