Danielle Clare Matuszak, COTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

5445-27 Issued in WI

Practice address

620 Grandview Ave
Blair, WI 54616-5461

Phone

(608) 989-2195

NPI assigned

Sep 26, 2017

Last updated

Mar 17, 2018By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1506384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1154830818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1022 25TH ST S",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546016091",
            "telephone_number": "608-732-0944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 GRANDVIEW AVE",
            "city": "BLAIR",
            "state": "WI",
            "postal_code": "546165461",
            "telephone_number": "608-989-2195"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13197 Church Street",
            "address_purpose": "LOCATION",
            "city": "Pigeon Falls",
            "state": "WI",
            "postal_code": "54760",
            "country_code": "US",
            "telephone_number": "715-983-2293 x4031",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATUSZAK",
        "first_name": "DANIELLE",
        "middle_name": "CLARE",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-26",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "WI",
            "license": "5445-27",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapy Assistant in Blair, WI
• Providers in Blair, WI by specialty
• Occupational Therapy Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.