Individual provider Active NPI

Patricia Alyse Musall, OTD, OTR/L

  • Occupational Therapist
  • Warsaw, IN
National Provider Identifier
1083193650
Registry record updated Aug 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
31006713A Issued in IN
Practice address
902 Provident Dr Ste C
Warsaw, IN 46580-3379
Phone
(574) 376-2316
Fax
(574) 306-2208
NPI assigned
Aug 14, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2018

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 31006713A IN Primary

Addresses

Primary practice location

902 Provident Dr Ste C
Warsaw, IN 46580-3379

Mailing address

902 Provident Dr Ste C
Warsaw, IN 46580-3379
Phone (574) 376-2316

Other identifiers 1

IdentifierTypeStateIssuer
31006713AOtherINOCCUPATIONAL THERAPY LICENSE

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
31006713AINMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Joes Kids Inc Occupational Therapist PastSince Feb 11, 2024 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": "1534204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534204800000",
    "number": "1083193650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 PROVIDENT DR STE C",
            "city": "WARSAW",
            "state": "IN",
            "postal_code": "465803379",
            "telephone_number": "574-376-2316",
            "fax_number": "574-306-2208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 PROVIDENT DR STE C",
            "city": "WARSAW",
            "state": "IN",
            "postal_code": "465803379",
            "telephone_number": "574-376-2316",
            "fax_number": "574-306-2208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUSALL",
        "first_name": "PATRICIA",
        "middle_name": "ALYSE",
        "name_prefix": "Miss",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-14",
        "last_updated": "2018-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IN",
            "license": "31006713A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OCCUPATIONAL THERAPY LICENSE",
            "identifier": "31006713A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warsaw, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2018; 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.