Individual provider Active NPI

Matthew P O'Toole, OTR/L

  • Occupational Therapist
  • Socorro, NM
National Provider Identifier
1104572874
Registry record updated Feb 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT4625 Issued in NM
Practice address
1202 Highway 60
Socorro, NM 87801-3914
Phone
(575) 835-8761
NPI assigned
Feb 22, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT4625 NM Primary

Addresses

Primary practice location

1202 Highway 60
Socorro, NM 87801-3914

Mailing address

1202 Highway 60
Socorro, NM 87801-3914
Phone (575) 835-8761

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
OT4625NMMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1645488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645488000000",
    "number": "1104572874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 HIGHWAY 60",
            "city": "SOCORRO",
            "state": "NM",
            "postal_code": "878013914",
            "telephone_number": "575-835-8761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 HIGHWAY 60",
            "city": "SOCORRO",
            "state": "NM",
            "postal_code": "878013914",
            "telephone_number": "575-835-8761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'TOOLE",
        "first_name": "MATTHEW",
        "middle_name": "P",
        "name_prefix": "Mr.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-22",
        "last_updated": "2022-02-22",
        "certification_date": "2022-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NM",
            "license": "OT4625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Socorro, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2022; 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.