Maraya Lynn Vanbrocklin, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

023373-1 Issued in NY

Practice address

453 Gaffney Dr
Watertown, NY 13601-1834

Phone

(315) 836-1227

NPI assigned

Mar 22, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Nysarc Inc. Onondaga County ChapterGroup PAC ID 9537252184, 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Nysarc Inc. Onondaga County Chapter

  • Developmental Disabilities Clinic/Center
  • Syracuse, NY
  • NPI 1043397490
  Medicare reassignment Care Compare group
• Essex County Chapter, Nysarc, Inc.

  • Early Intervention Provider Agency
  • Port Henry, NY
  • NPI 1427134451
  Medicare reassignment NPD
• New Dimensions in Living Inc

  • Multi-Specialty Clinic/Center
  • Amsterdam, NY
  • NPI 1982674917
  NPD (past)

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

{
    "created_epoch": "1553212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660176000000",
    "number": "1144780529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 CAROLINE ST",
            "city": "OGDENSBURG",
            "state": "NY",
            "postal_code": "136693304",
            "telephone_number": "315-323-5463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "453 GAFFNEY DR",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136011834",
            "telephone_number": "315-836-1227"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6 Commerce Ln",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "NY",
            "postal_code": "136173738",
            "country_code": "US",
            "telephone_number": "315-379-9571",
            "fax_number": "315-379-0834",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANBROCKLIN",
        "first_name": "MARAYA",
        "middle_name": "LYNN",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-22",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "023373-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vanessa Vallance, CASAC-T
• Dameree Grace Van Aken, PHARMD
• Ruth-Ellen Van Arnam, R.PH.
• Chelsea Vanarnam, OTR/L
• Macy Vanarnam, M.D.
• Mary Vanbrocklin
• Lee M. Vance, PSY.D.
• Rosina D Vandewall, PHARMD
• D. Peter Vaneenenaam, M.D.
• David O Vaneenenaam, M.D.

• Occupational Therapist in Watertown, NY
• Providers in Watertown, NY by specialty
• Occupational Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.