NPIMap

Individual provider Active NPI

Amy Elizabeth Villalobos, OT/R

  • Gerontology Occupational Therapist
  • East Longmeadow, MA
National Provider Identifier
1083161145
Registry record updated Apr 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Occupational TherapistTaxonomy code 225XG0600X
License
12191 Issued in MA
Practice address
16 Converse Cir
East Longmeadow, MA 01028-1906
Phone
(413) 847-1212
NPI assigned
Sep 7, 2016
Last updated
Apr 29, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 12191 MA
Neurorehabilitation Occupational Therapist 225XN1300X 16542658 CT
Pediatric Occupational Therapist 225XP0200X 900839666 MA
Gerontology Occupational Therapist 225XG0600X 12191 MA Primary

Addresses

Primary practice location

16 Converse Cir
East Longmeadow, MA 01028-1906

Mailing address

16 Converse Cir
East Longmeadow, MA 01028-1906
Phone (413) 847-1212

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address loomis.senior.living@selectrehab.com Direct

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

LicenseStateTypeSpecialty
12191MAMDMental Health Counselor
16542658CTMDNeurorehabilitation Occupational Therapist
900839666MAMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Select PT, OT & SLP Rehabilitation Ny PLLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: loomis.senior.living@selectrehab.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1473206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619654400000",
    "number": "1083161145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 CONVERSE CIR",
            "city": "EAST LONGMEADOW",
            "state": "MA",
            "postal_code": "010281906",
            "telephone_number": "413-847-1212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 CONVERSE CIR",
            "city": "EAST LONGMEADOW",
            "state": "MA",
            "postal_code": "010281906",
            "telephone_number": "413-847-1212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLALOBOS",
        "first_name": "AMY",
        "middle_name": "ELIZABETH",
        "credential": "OT/R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-07",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MA",
            "license": "12191",
            "primary": false
        },
        {
            "code": "225XN1300X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Neurorehabilitation",
            "state": "CT",
            "license": "16542658",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "MA",
            "license": "900839666",
            "primary": false
        },
        {
            "code": "225XG0600X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Gerontology",
            "state": "MA",
            "license": "12191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "loomis.senior.living@selectrehab.com",
            "affiliation": "N",
            "endpointDescription": "secure company email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "informational",
            "address_1": "807 Wilbraham Rd",
            "city": "Springfield",
            "state": "MA",
            "country_code": "US",
            "postal_code": "011092067",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in East Longmeadow, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2021; 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.