Active NPI
Ian Schneider
- Occupational Therapy Assistant
- Newport, VT
National Provider Identifier
1124507033
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 073.0900339PROV
- Practice address
- 35 Bel Aire Dr
Newport, VT 05855-4953 - Phone
- (802) 334-2878
- NPI assigned
- Aug 10, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 009819 | NY | |
| Occupational Therapy Assistant | 224Z00000X | 073.0900339PROV | VT | Primary |
| Occupational Therapy Assistant | 224Z00000X | OTP-OTA-LIC-6122 | MT |
Addresses
Primary practice location
35 Bel Aire Dr
Newport, VT 05855-4953
Mailing address
1158 N Country Club Dr
Niskayuna, NY 12309-5406
Phone (406) 419-8549
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124507033 | Medicaid | MT | |
| 1124507033 | Medicaid | NY |
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 |
|---|---|---|---|
| 009819 | NY | MD | Optician |
| OTP-OTA-LIC-6122 | MT | MD | Occupational Therapy Assistant |
| 073.0900339PROV | VT | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1533859200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1776729600000",
"number": "1124507033",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1158 N COUNTRY CLUB DR",
"city": "NISKAYUNA",
"state": "NY",
"postal_code": "123095406",
"telephone_number": "406-419-8549"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "35 BEL AIRE DR",
"city": "NEWPORT",
"state": "VT",
"postal_code": "058554953",
"telephone_number": "802-334-2878"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHNEIDER",
"first_name": "IAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-08-10",
"last_updated": "2026-04-21",
"certification_date": "2026-04-21",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "NY",
"license": "009819",
"primary": false
},
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "VT",
"license": "073.0900339PROV",
"primary": true
},
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "MT",
"license": "OTP-OTA-LIC-6122",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1124507033",
"state": "MT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1124507033",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Newport, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.