Individual provider Active NPI

Samantha Rae Willard, MS, OTR/L

  • Occupational Therapist
  • Buffalo, NY
National Provider Identifier
1235005687
Registry record updated Oct 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
030656 Issued in NY
Practice address
1585 Hertel Ave
Buffalo, NY 14216-2997
Phone
(716) 815-4415
NPI assigned
Oct 14, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 030656 NY Primary

Addresses

Primary practice location

1585 Hertel Ave
Buffalo, NY 14216-2997

Mailing address

93 Huron St
Hamburg, NY 14075-6105
Phone (716) 364-5674

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251111003567 NY Practitioner - Occupational Therapist in Private Practice 8820589419 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1585 Hertel Ave
Suite 100
Buffalo, NY 14216-2997
Phone (716) 815-4415

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
030656NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Buffalo Rehab Group Physical Therapy and Occupational Therapy PC CurrentSince Oct 20, 2025 Accepting new patients

Locations

8000 Box
Buffalo, NY 14267
Phone (716) 213-0772

230 Main St
East Aurora, NY 14052
Phone (716) 333-8723

2100 Union Rd
West Seneca, NY 14224
Phone (716) 656-8600

Organizations & group practices 1

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": "1760400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760400000000",
    "number": "1235005687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "93 HURON ST",
            "city": "HAMBURG",
            "state": "NY",
            "postal_code": "140756105",
            "telephone_number": "716-364-5674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1585 HERTEL AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142162997",
            "telephone_number": "716-815-4415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLARD",
        "first_name": "SAMANTHA",
        "middle_name": "RAE",
        "credential": "MS, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-14",
        "last_updated": "2025-10-14",
        "certification_date": "2025-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "030656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2025; 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.