Individual provider Active NPI

Makenzie Lee Muck, COTA

  • Occupational Therapy Assistant
  • Buffalo, NY
National Provider Identifier
1104594043
Registry record updated Sep 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
Practice address
2495 Main St Ste 234
Buffalo, NY 14214-2152
Phone
(716) 836-5929
NPI assigned
Sep 3, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2021

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 NY Primary

Addresses

Primary practice location

2495 Main St Ste 234
Buffalo, NY 14214-2152

Mailing address

1610 N Lyndonville Rd
Lyndonville, NY 14098-9602
Phone (585) 590-9174

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

Practice roles

OrganizationSpecialtyStatusNew patients
Optimal Occupational and Physical Therapy Associates Services PLLC PastSince Sep 5, 2021 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1630627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630627200000",
    "number": "1104594043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1610 N LYNDONVILLE RD",
            "city": "LYNDONVILLE",
            "state": "NY",
            "postal_code": "140989602",
            "telephone_number": "585-590-9174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2495 MAIN ST STE 234",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142142152",
            "telephone_number": "716-836-5929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUCK",
        "first_name": "MAKENZIE",
        "middle_name": "LEE",
        "name_prefix": "Miss",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-03",
        "last_updated": "2021-09-03",
        "certification_date": "2021-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2021; 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.