Individual provider Active NPI

Kristen Menzel, COTA

  • Occupational Therapy Assistant
  • North Tonawanda, NY
National Provider Identifier
1104632934
Registry record updated Dec 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
006707-7 Issued in NY
Practice address
4834 Meyer Rd
North Tonawanda, NY 14120-9579
Phone
(716) 308-4891
NPI assigned
Dec 6, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2024

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 006707-7 NY Primary

Addresses

Primary practice location

4834 Meyer Rd
North Tonawanda, NY 14120-9579

Mailing address

4834 Meyer Rd
North Tonawanda, NY 14120-9579
Phone (716) 308-4891

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
006707-7NYMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1733443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733443200000",
    "number": "1104632934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4834 MEYER RD",
            "city": "NORTH TONAWANDA",
            "state": "NY",
            "postal_code": "141209579",
            "telephone_number": "716-308-4891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4834 MEYER RD",
            "city": "NORTH TONAWANDA",
            "state": "NY",
            "postal_code": "141209579",
            "telephone_number": "716-308-4891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENZEL",
        "first_name": "KRISTEN",
        "name_prefix": "Ms.",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-06",
        "last_updated": "2024-12-06",
        "certification_date": "2024-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NY",
            "license": "006707-7",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Tonawanda, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2024; 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.