Individual provider Active NPI

Amanda Flores Macha, OT

  • Occupational Therapist
  • Odessa, TX
National Provider Identifier
1154942530
Registry record updated Mar 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
119661 Issued in TX
Practice address
4010 Medical Park Dr
Odessa, TX 79765-2233
Phone
(432) 614-0268
Fax
(888) 972-6512
NPI assigned
Apr 27, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X
Occupational Therapist 225X00000X 119661 TX Primary

Addresses

Primary practice location

4010 Medical Park Dr
Odessa, TX 79765-2233

Mailing address

6408 Vanguard Rd
Midland, TX 79706-2974
Phone (682) 206-5520

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240403002113 TX Practitioner - Occupational Therapist in Private Practice 3072951599 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
119661TXMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Therapy of Texas Occupational Therapist CurrentSince Mar 4, 2024 Accepting new patients
Tanya Manriquez Lujan M.S., CCC-SLP, PLLC Occupational Therapist CurrentSince Mar 4, 2024 Accepting new patients
West Texas Centers for MHMR PastSince May 1, 2020 Accepting new patients
Paso del Norte Children'S Development Center PastSince May 1, 2020 Accepting new patients

Locations

4010 Medical Park Dr
Odessa, TX 79765
Phone (432) 614-0268

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1587945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742428800000",
    "number": "1154942530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6408 VANGUARD RD",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797062974",
            "telephone_number": "682-206-5520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4010 MEDICAL PARK DR",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797652233",
            "telephone_number": "432-614-0268",
            "fax_number": "888-972-6512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACHA",
        "first_name": "AMANDA",
        "middle_name": "FLORES",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-27",
        "last_updated": "2025-03-20",
        "certification_date": "2025-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "119661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Odessa, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.