Active NPI
Alan Mortellaro, OTR/L
- Occupational Therapist
- Girard, PA
National Provider Identifier
1003122102
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OC003659
- Practice address
- 8300 Ridge Rd
Girard, PA 16417-8701 - Phone
- (814) 474-5521
- Fax
- (814) 474-2307
- NPI assigned
- Aug 26, 2010
- 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 | OC003659 | PA | Primary |
Addresses
Primary practice location
8300 Ridge Rd
Girard, PA 16417-8701
Mailing address
8300 Ridge Rd
Girard, PA 16417-8701
Phone (814) 474-5521
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
| License | State | Type | Specialty |
|---|---|---|---|
| OC003659 | PA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1282780800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1282780800000",
"number": "1003122102",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8300 RIDGE RD",
"city": "GIRARD",
"state": "PA",
"postal_code": "164178701",
"telephone_number": "814-474-5521",
"fax_number": "814-474-2307"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8300 RIDGE RD",
"city": "GIRARD",
"state": "PA",
"postal_code": "164178701",
"telephone_number": "814-474-5521",
"fax_number": "814-474-2307"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORTELLARO",
"first_name": "ALAN",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-08-26",
"last_updated": "2010-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "PA",
"license": "OC003659",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Girard, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.