Individual provider Active NPI

Mara M. Mateo, O.T.

  • Pediatric Occupational Therapist
  • San Juan, PR
National Provider Identifier
1104121979
Registry record updated Jan 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
1034 Issued in PR
Practice address
344 Ave Americo Miranda
San Juan, PR 00927-5111
Phone
(787) 689-7785
NPI assigned
Jan 25, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 1034 PR
Pediatric Occupational Therapist 225XP0200X 1034 PR Primary

Addresses

Primary practice location

344 Ave Americo Miranda
San Juan, PR 00927-5111

Mailing address

PO Box 8796
Caguas, PR 00726-8796
Phone (787) 209-2357

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
1034PRMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1295913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295913600000",
    "number": "1104121979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8796",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "007268796",
            "telephone_number": "787-209-2357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "344 AVE AMERICO MIRANDA",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009275111",
            "telephone_number": "787-689-7785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATEO",
        "first_name": "MARA",
        "middle_name": "M.",
        "name_prefix": "Miss",
        "credential": "O.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-25",
        "last_updated": "2011-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "PR",
            "license": "1034",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "PR",
            "license": "1034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2011; 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.