Individual provider Active NPI

George Mwangi

  • Occupational Therapist
  • Fair Lawn, NJ
National Provider Identifier
1114951464
Registry record updated Dec 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
009765-1 Issued in NY
Practice address
12-45 River Rd # 317
Fair Lawn, NJ 07410-1812
Phone
(862) 684-1789
Fax
(201) 797-0410
NPI assigned
Jul 11, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 2023

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 46TR00076600 NJ
Occupational Therapist 225X00000X 009765-1 NY Primary

Addresses

Primary practice location

12-45 River Rd # 317
Fair Lawn, NJ 07410-1812

Mailing address

12-45 River Rd # 317
Fair Lawn, NJ 07410-1812
Phone (862) 684-1789

Other names 1

  • Mr. George Mwangi Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20130711000025 NY Practitioner - Occupational Therapist in Private Practice 8527208768 Reassigns benefits to 4 organizations
I20180530000208 NJ Practitioner - Occupational Therapist in Private Practice 8527208768 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
009765-1NYMDPsychologist
46TR00076600NJMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Epic Long Island CurrentSince Apr 1, 2016 Accepting new patients
GM Rehab Services LLC Occupational Therapist CurrentSince Dec 10, 2023 Accepting new patients
Global SLP OT PT & Psychological Services, PLLC Occupational Therapist CurrentSince Jan 1, 2021 Accepting new patients
Lifespire, Inc. CurrentSince Jan 1, 2015 Accepting new patients
Way Rehab Services CurrentSince Jun 15, 2022 Accepting new patients
Epilepsy Foundation of L.I. CurrentSince Apr 1, 2016 Accepting new patients
Epic Medical Services PC CurrentSince Apr 1, 2016 Accepting new patients
Lifespire, Inc. CurrentSince Jan 1, 2015 Accepting new patients
GM Rehab Services LLC Occupational Therapist CurrentSince Apr 20, 2018 Accepting new patients

Locations

12-45 River Rd
Ste 317
Fair Lawn, NJ 07410
Phone (862) 684-1789

12-45 River Rd
#317
Fair Lawn, NJ 07410
Phone (862) 684-1789

21301 Northern Blvd
Fl 2
Bayside, NY 11361
Phone (718) 721-5444

1500 Hempstead Tpke
East Meadow, NY 11554
Phone 51673977331420

16210 Jamaica Ave
Ste 7
Jamaica, NY 11432
Phone (718) 454-2700

1979 Marcus Ave
Ste 204
New Hyde Park, NY 11042
Phone (516) 327-4681

159 E 125th St
Fl 2
New York, NY 10035
Phone (212) 360-5600

Organizations & group practices 9

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": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701907200000",
    "number": "1114951464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12-45 RIVER RD # 317",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074101812",
            "telephone_number": "862-684-1789",
            "fax_number": "201-797-0410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12-45 RIVER RD # 317",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074101812",
            "telephone_number": "862-684-1789",
            "fax_number": "201-797-0410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MWANGI",
        "first_name": "GEORGE",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2023-12-07",
        "certification_date": "2023-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NJ",
            "license": "46TR00076600",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "009765-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GEORGE",
            "last_name": "MWANGI",
            "prefix": "MR.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Fair Lawn, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.