Active NPI
Marilou Bastian, OTR/L
- Pediatric Occupational Therapist
- Jensen Beach, FL
National Provider Identifier
1124396114
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- OT 9616
- Practice address
- 4492 NE Ocean Blvd Apt C1
Jensen Beach, FL 34957-4354 - Phone
- (772) 285-9957
- NPI assigned
- Dec 6, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | OT 9616 | FL | Primary |
Addresses
Primary practice location
4492 NE Ocean Blvd Apt C1
Jensen Beach, FL 34957-4354
Mailing address
4492 NE Ocean Blvd Apt C1
Jensen Beach, FL 34957-4354
Phone (772) 285-9957
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
| License | State | Type | Specialty |
|---|---|---|---|
| OT 9616 | FL | MD | Pediatric Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1323129600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1378857600000",
"number": "1124396114",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4492 NE OCEAN BLVD APT C1",
"city": "JENSEN BEACH",
"state": "FL",
"postal_code": "349574354",
"telephone_number": "772-285-9957"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4492 NE OCEAN BLVD APT C1",
"city": "JENSEN BEACH",
"state": "FL",
"postal_code": "349574354",
"telephone_number": "772-285-9957"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BASTIAN",
"first_name": "MARILOU",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-12-06",
"last_updated": "2013-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "FL",
"license": "OT 9616",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jensen Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.