DOMINIQUE BASSALLO OT
NPI 1972437549
Occupational Therapist in Latham, NY

Active since June 10, 2026
711 TROY SCHENECTADY RD STE 216, LATHAM, NY 12110(518) 786-1667(518) 786-1954 Get Directions Write a Review

NPPES record last updated: June 10, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dominique Bassallo Ot NPPES

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

DOMINIQUE BASSALLO OT (NPI 1972437549) is an individual occupational therapist in Latham, New York, licensed in New York (031090) and active in the NPI registry since June 2026. She is a graduate of Other (2025).

NPPES Registry Identity

NPI1972437549
Entity TypeIndividualFemale
Primary Taxonomy225X00000X
Provider Legal NameDOMINIQUE BASSALLOCredential: OT
Location Address711 TROY SCHENECTADY RD STE 216Latham, NY 12110-2461
Mailing Address122 Remsen StCohoes, NY 12047-2968 · (518) 416-3780
Fax(518) 786-1954
Sole ProprietorNo
Medical School CMSOtherGraduated 2025
Enumeration DateJune 10, 2026
NPPES CertifiedJune 10, 2026
✔ NPI 1972437549 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 · 031090
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.
711 TROY SCHENECTADY RD STE 216, Latham, NY 12110

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dominique Bassallo Ot is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID9335611532
PECOS Enrollment IDI20260618002709

Medicare Billing Reassignment

Medicare enrollment records show Dominique Bassallo reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Specialist
711 TROY SCHENECTADY RD, SUITE 209
Latham, NY 12110
  • Reassigned Medicare billing, New York enrollment
  • 59 clinicians in this Medicare group

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 11

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

Physical Therapist
711 TROY SCHENECTADY RD STE 216
LATHAM, NY 12110
Occupational Therapist (Pediatrics)
711 TROY SCHENECTADY RD STE 216
LATHAM, NY 12110
Occupational Therapist
711 TROY SCHENECTADY RD STE 216
LATHAM, NY 12110
Physical Therapist
711 TROY SCHENECTADY RD STE 216
LATHAM, NY 12110
Occupational Therapist
711 TROY SCHENECTADY RD STE 216
LATHAM, NY 12110
Physical Therapist
711 TROY SCHENECTADY RD STE 216
LATHAM, NY 12110
Occupational Therapist
711 TROY SCHENECTADY RD STE 216
LATHAM, NY 12110
Physical Therapist
711 TROY SCHENECTADY RD STE 216
LATHAM, NY 12110

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 Dominique Bassallo's NPI number?

The NPI number for Dominique Bassallo is 1972437549. It was assigned to this individual provider in the NPPES registry on June 10, 2026.

Where is Dominique Bassallo located?

Dominique Bassallo practices at 711 Troy Schenectady Rd Ste 216, Latham, NY 12110. The listed phone number is (518) 786-1667.

What is Dominique Bassallo's specialty?

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

Is Dominique Bassallo enrolled in Medicare?

Yes. Dominique Bassallo is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Dominique Bassallo's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Dominique Bassallo reassigns Medicare benefits to Nicolla And Associates, Pt & Ot Services, PLLC (Latham, NY). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Dominique Bassallo's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Dominique Bassallo was last updated on June 10, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months 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.