Anna Derbak, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

7412 Issued in AZ

Practice address

16455 E Avenue of the Fountains
Fountain Hills, AZ 85268-8307

Phone

(480) 816-5805

Fax

(480) 816-5807

NPI assigned

May 7, 2018

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

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

{
    "created_epoch": "1525651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525651200000",
    "number": "1194214965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4434 E CAROL ANN LN",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850324257",
            "telephone_number": "602-334-6184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16455 E AVENUE OF THE FOUNTAINS",
            "city": "FOUNTAIN HILLS",
            "state": "AZ",
            "postal_code": "852688307",
            "telephone_number": "480-816-5805",
            "fax_number": "480-816-5807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERBAK",
        "first_name": "ANNA",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-07",
        "last_updated": "2018-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "AZ",
            "license": "7412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter Michael Dellios, DDS
• Alexandria L. Demeo
• Brianna Rene Dendauw, MS
• Megan Joanne Denison, M.S., CCC-SLP
• Rebecca Dent, M.A.
• Dermright LLC
• Desert Community Medical Associates
• Desert Family Home Health LLC
• Desert Foot & Ankle P C
• Desert Fountain Medical Inc

• Occupational Therapy Assistant in Fountain Hills, AZ
• Providers in Fountain Hills, AZ by specialty
• Occupational Therapy Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 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.