Individual provider Active NPI

Michael Carrington Lane, COTA/L

  • Occupational Therapy Assistant
  • Eastchester, NY
National Provider Identifier
1104344795
Registry record updated Sep 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
009251-1 Issued in NY
Practice address
550 White Plains Rd
Eastchester, NY 10709-5506
Phone
(914) 793-6130
NPI assigned
Sep 2, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2017

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 009251-1 NY Primary

Addresses

Primary practice location

550 White Plains Rd
Eastchester, NY 10709-5506

Mailing address

79 Westchester SQ Apt 2F
Bronx, NY 10461-3546

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
009251-1NYMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1504310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504310400000",
    "number": "1104344795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 WESTCHESTER SQ APT 2F",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104613546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 WHITE PLAINS RD",
            "city": "EASTCHESTER",
            "state": "NY",
            "postal_code": "107095506",
            "telephone_number": "914-793-6130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANE",
        "first_name": "MICHAEL",
        "middle_name": "CARRINGTON",
        "name_prefix": "Mr.",
        "credential": "COTA/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-09-02",
        "last_updated": "2017-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NY",
            "license": "009251-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eastchester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2017; 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.