Individual provider Active NPI

Alexandra L Marston, OT

  • Occupational Therapist
  • Melbourne, FL
National Provider Identifier
1053849968
Registry record updated Sep 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
18508 Issued in FL
Practice address
7000 Spyglass CT Ste 120
Melbourne, FL 32940-7948
Phone
(321) 241-6543
Fax
(321) 241-6513
NPI assigned
May 23, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 18508 FL Primary

Addresses

Primary practice location

7000 Spyglass CT Ste 120
Melbourne, FL 32940-7948

Mailing address

7000 Spyglass CT Ste 120
Melbourne, FL 32940-7948
Phone (321) 241-6543

Other practice location 1

4112 Melrose Ct
Melbourne, FL 32940-1472
Phone (321) 794-6551

Other names 1

  • Alexandra L McDaniel Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200911001171 FL Practitioner - Occupational Therapist in Private Practice 0244658912 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Space Coast Lymphedema Clinic LLCGroup PAC ID 9638495724, 6 clinicians

Practice addresses (Care Compare)

7000 Spyglass CT
Suite 120
Viera, FL 32940-7948
Phone (321) 241-6543

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18508FLMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Space Coast Lymphedema Clinic LLC Occupational Therapist CurrentSince Aug 10, 2020 Accepting new patients

Locations

8055 Spyglass Hill Rd
Ste 103
Viera, FL 32940
Phone (321) 241-6543

7000 Spyglass Ct
Ste 120
Viera, FL 32940
Phone (321) 241-6543

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": "1495497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599782400000",
    "number": "1053849968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7000 SPYGLASS CT STE 120",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329407948",
            "telephone_number": "321-241-6543",
            "fax_number": "321-241-6513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7000 SPYGLASS CT STE 120",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329407948",
            "telephone_number": "321-241-6543",
            "fax_number": "321-241-6513"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4112 Melrose Ct",
            "address_purpose": "LOCATION",
            "city": "Melbourne",
            "state": "FL",
            "postal_code": "329401472",
            "country_code": "US",
            "telephone_number": "321-794-6551",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARSTON",
        "first_name": "ALEXANDRA",
        "middle_name": "L",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-23",
        "last_updated": "2020-09-11",
        "certification_date": "2020-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "18508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALEXANDRA",
            "last_name": "MCDANIEL",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Sep 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.