Ami Marie Gydesen, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

0058651 Issued in NY

Practice address

22567 Summit Dr BLDG 2
Watertown, NY 13601-7210

Phone

(315) 779-6784

NPI assigned

Sep 15, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Miss Ami Marie Denson Former name

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Samaritan Medical Practice PCGroup PAC ID 5698853133, 29 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: agydesen@samaritanmedicalpractice.medentdirect.com

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.

• Samaritan Medical Practice, PC

  • Surgery Physician
  • Watertown, NY
  • NPI 1124202619
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713830400000",
    "number": "1093811549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22567 SUMMIT DR BLDG 2",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136017210",
            "telephone_number": "315-779-6784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22567 SUMMIT DR BLDG 2",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136017210",
            "telephone_number": "315-779-6784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GYDESEN",
        "first_name": "AMI",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-15",
        "last_updated": "2024-04-23",
        "certification_date": "2024-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "0058651",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04329911",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMI",
            "last_name": "DENSON",
            "middle_name": "MARIE",
            "prefix": "MISS",
            "credential": "OTR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Occupational Therapist in Watertown, NY
• Providers in Watertown, NY by specialty
• Occupational Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2024; 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.