Individual provider Active NPI

Mary Hein, COTA

  • Occupational Therapy Assistant
  • Waukesha, WI
National Provider Identifier
1093410466
Registry record updated Apr 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
7042-27 Issued in WI
Practice address
S11W29667 Summit Ave
Waukesha, WI 53188-9476
Phone
(262) 565-6124
NPI assigned
Apr 4, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 7042-27 WI Primary

Addresses

Primary practice location

S11W29667 Summit Ave
Waukesha, WI 53188-9476

Mailing address

S87W24855 Edgewood Ave
Big Bend, WI 53103-9797
Phone (262) 378-1831

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
7042-27WIMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lifestriders, Inc. PastSince Apr 9, 2023 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, 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": "1680566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680566400000",
    "number": "1093410466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "S87W24855 EDGEWOOD AVE",
            "city": "BIG BEND",
            "state": "WI",
            "postal_code": "531039797",
            "telephone_number": "262-378-1831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "S11W29667 SUMMIT AVE",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531889476",
            "telephone_number": "262-565-6124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEIN",
        "first_name": "MARY",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-04",
        "last_updated": "2023-04-04",
        "certification_date": "2023-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "WI",
            "license": "7042-27",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukesha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2023; 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.