Individual provider Active NPI

Michelle Delyser, OTR/L

  • Occupational Therapist
  • Marion, NY
National Provider Identifier
1043791692
Registry record updated Jan 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
020662-1 Issued in NY
Practice address
3525 Sand Hill Rd
Marion, NY 14505-9563
Phone
(315) 573-8275
Fax
(585) 282-0099
NPI assigned
Aug 22, 2018
Last updated
Jan 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 19, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 020662 NY
Occupational Therapist 225X00000X 020662-1 NY Primary

Addresses

Primary practice location

3525 Sand Hill Rd
Marion, NY 14505-9563

Mailing address

3525 Sand Hill Rd
Marion, NY 14505-9563
Phone (315) 573-8275

Other identifiers 1

IdentifierTypeStateIssuer
020662-1OtherNYNBCOT

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

LicenseStateTypeSpecialty
020662NYMDOccupational Therapist
020662-1NYMDOccupational Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1534896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705622400000",
    "number": "1043791692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3525 SAND HILL RD",
            "city": "MARION",
            "state": "NY",
            "postal_code": "145059563",
            "telephone_number": "315-573-8275",
            "fax_number": "585-282-0099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3525 SAND HILL RD",
            "city": "MARION",
            "state": "NY",
            "postal_code": "145059563",
            "telephone_number": "315-573-8275",
            "fax_number": "585-282-0099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELYSER",
        "first_name": "MICHELLE",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-22",
        "last_updated": "2024-01-19",
        "certification_date": "2024-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "020662",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "020662-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NBCOT",
            "identifier": "020662-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.