Active NPI
Vidya Lystra Mathura
- Pediatric Occupational Therapist
- Bronx, NY
National Provider Identifier
1093015299
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- 018126-1
- Practice address
- 4125 Carpenter Avenue
Bronx, NY 10466-1069 - Phone
- (718) 655-0261
- Fax
- (718) 654-7930
- NPI assigned
- Oct 22, 2010
- 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 |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | 018126-1 | NY | Primary |
Addresses
Primary practice location
4125 Carpenter Avenue
Bronx, NY 10466-1069
Mailing address
1186 King St
Rye Brook, NY 10573-1069
Phone (914) 937-3800
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
| License | State | Type | Specialty |
|---|---|---|---|
| 018126-1 | NY | MD | Pediatric Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1287705600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1378944000000",
"number": "1093015299",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1186 KING ST",
"city": "RYE BROOK",
"state": "NY",
"postal_code": "105731069",
"telephone_number": "914-937-3800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4125 CARPENTER AVENUE",
"city": "BRONX",
"state": "NY",
"postal_code": "104661069",
"telephone_number": "718-655-0261",
"fax_number": "718-654-7930"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATHURA",
"first_name": "VIDYA",
"middle_name": "LYSTRA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-10-22",
"last_updated": "2013-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "NY",
"license": "018126-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.