Individual provider Active NPI

Stacy Augustyn, OTR

  • Occupational Therapist
  • Watchung, NJ
National Provider Identifier
1124340393
Registry record updated Jun 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
46TR00510200 Issued in NJ
Practice address
1633 US Highway 22
Watchung, NJ 07069-6505
Phone
(908) 754-3663
NPI assigned
Feb 15, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2020

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 46TR00510200 NJ Primary

Addresses

Primary practice location

1633 US Highway 22
Watchung, NJ 07069-6505

Mailing address

1633 US Highway 22
Watchung, NJ 07069-6505

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
46TR00510200NJMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1266192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591747200000",
    "number": "1124340393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1633 US HIGHWAY 22",
            "city": "WATCHUNG",
            "state": "NJ",
            "postal_code": "070696505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1633 US HIGHWAY 22",
            "city": "WATCHUNG",
            "state": "NJ",
            "postal_code": "070696505",
            "telephone_number": "908-754-3663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AUGUSTYN",
        "first_name": "STACY",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-15",
        "last_updated": "2020-06-10",
        "certification_date": "2020-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NJ",
            "license": "46TR00510200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watchung, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2020; 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.