Individual provider Active NPI

Mychal S Petti

  • Occupational Therapy Assistant
  • Mahopac, NY
National Provider Identifier
1184533309
Registry record updated Sep 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
011755 Issued in NY
Practice address
263 Rockledge Rd
Mahopac, NY 10541-1214
Phone
(845) 341-8317
NPI assigned
Sep 3, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 011755 NY Primary

Addresses

Primary practice location

263 Rockledge Rd
Mahopac, NY 10541-1214

Mailing address

263 Rockledge Rd
Mahopac, NY 10541-1214

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1788393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788393600000",
    "number": "1184533309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "263 ROCKLEDGE RD",
            "city": "MAHOPAC",
            "state": "NY",
            "postal_code": "105411214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "263 ROCKLEDGE RD",
            "city": "MAHOPAC",
            "state": "NY",
            "postal_code": "105411214",
            "telephone_number": "845-341-8317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTI",
        "first_name": "MYCHAL",
        "middle_name": "S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-09-03",
        "last_updated": "2026-09-03",
        "certification_date": "2026-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NY",
            "license": "011755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mahopac, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.