Active NPI
Amaisa Garcia Changcoco
- Occupational Therapist
- Melbourne, FL
National Provider Identifier
1053513556
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 12681
- Practice address
- 3040 N Wickham Rd Ste 7
Melbourne, FL 32935-2369 - Phone
- (321) 255-9546
- Fax
- (321) 255-4690
- NPI assigned
- Jun 5, 2007
- Sex
- Female
- Sole proprietor
- No
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 | 12681 | FL | Primary |
Addresses
Primary practice location
3040 N Wickham Rd Ste 7
Melbourne, FL 32935-2369
Mailing address
3040 N Wickham Rd Ste 7
Melbourne, FL 32935-2369
Phone (321) 255-9546
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12681 | FL | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rehab Specialists East Coast | Occupational Therapist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181001600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1053513556",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3040 N WICKHAM RD STE 7",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329352369",
"telephone_number": "321-255-9546",
"fax_number": "321-255-4690"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3040 N WICKHAM RD STE 7",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329352369",
"telephone_number": "321-255-9546",
"fax_number": "321-255-4690"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHANGCOCO",
"first_name": "AMAISA",
"middle_name": "GARCIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "FL",
"license": "12681",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Melbourne, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.