MR. BRUCE DOUGLAS OTR LICENSE
NPI 1023233558
Occupational Therapist in Brooklyn, NY

Active since April 17, 2007Accepts Medicare Assignment
4319 CHURCH AVE, BROOKLYN, NY 11203(718) 978-3186(718) 221-5530 Get Directions Write a Review

NPPES record last updated: August 1, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mr. Bruce Douglas Otr License NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. BRUCE DOUGLAS OTR LICENSE (NPI 1023233558) is an individual occupational therapist in Brooklyn, New York, licensed in New York (005500) and active in the NPI registry since April 2007. He is a graduate of State University Of New York Downstate Medical Center (1991).

NPPES Registry Identity

NPI1023233558
Entity TypeIndividualMale
Primary Taxonomy225X00000X
Provider Legal NameMR. BRUCE DOUGLASCredential: OTR LICENSE
Location Address4319 CHURCH AVEBrooklyn, NY 11203-3101
Mailing Address609 Midwood StBrooklyn, NY 11203-1103 · (718) 978-3188 · Fax (718) 221-5530
Fax(718) 221-5530
Sole ProprietorNo
Medical School CMSState University Of New York Downstate Medical CenterGraduated 1991
Enumeration DateApril 17, 2007
Last NPPES UpdateAugust 1, 2013
NPI 1023233558 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyOccupational TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225X00000X
License Licensed in NY · 005500
Definition
An occupational therapist is a person who has graduated from an entry-level occupational therapy program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, or approved by the World Federation of Occupational Therapists (WFOT), or an equivalent international occupational therapy education program; has successfully completed a period of supervised fieldwork experience required by the occupational therapy program; has passed a nationally recognized entry-level examination for occupational therapists, and fulfills state requirements for licensure, certification, or registration. An occupational therapist provides interventions based on evaluation and which emphasize the therapeutic use of everyday life activities (i.e., occupations) with individuals or groups for the purpose of facilitating participation in roles and situations and in home, school, workplace, community and other settings. Occupational therapy services are provided for the purpose of promoting health and wellness and are provided to those who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction. Occupational therapists address the physical, cognitive, psychosocial, sensory, and other aspects of occupational performance in a variety of contexts to support engagement in everyday life activities that affect health, well-being, and quality of life.
4319 CHURCH AVE, Brooklyn, NY 11203

Other Identifiers 2

Medicare PINQT5641NY
Medicare UPINQ03232NY

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Mr. Bruce Douglas Otr License is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9638062318
PECOS Enrollment IDI20040317001420

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Occupational Therapist
4319 CHURCH AVE
BROOKLYN, NY 11203
Physical Therapist
4319 CHURCH AVE
BROOKLYN, NY 11203
Physical Therapist
4319 CHURCH AVE
BROOKLYN, NY 11203

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bruce Douglas's NPI number?

The NPI number for Bruce Douglas is 1023233558. It was assigned to this individual provider in the NPPES registry on April 17, 2007.

Where is Bruce Douglas located?

Bruce Douglas practices at 4319 Church Ave, Brooklyn, NY 11203. The listed phone number is (718) 978-3186.

What is Bruce Douglas's specialty?

The primary specialty registered for this NPI is Occupational Therapist with taxonomy code 225X00000X.

Is Bruce Douglas enrolled in Medicare?

Yes. Bruce Douglas is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Bruce Douglas was last updated on August 1, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.