Individual provider Active NPI

Mirah Sand, OTR/L

  • Pediatric Occupational Therapist
  • Jamaica Plain, MA
National Provider Identifier
1245729698
Registry record updated May 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
12643 Issued in MA
Practice address
Thom Boston Metro Early Intervention
555 Amory St
Jamaica Plain, MA 02130-2652
Phone
(617) 383-6522
NPI assigned
May 1, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 12643 MA Primary

Addresses

Primary practice location

Thom Boston Metro Early Intervention
555 Amory St
Jamaica Plain, MA 02130-2652

Mailing address

555 Amory St
Jamaica Plain, MA 02130-2652

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
12643MAMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mirah Sand LLC Current Accepting new patients

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": "1525132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525132800000",
    "number": "1245729698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 AMORY ST",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021302652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "THOM BOSTON METRO EARLY INTERVENTION",
            "address_2": "555 AMORY ST",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021302652",
            "telephone_number": "617-383-6522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAND",
        "first_name": "MIRAH",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-01",
        "last_updated": "2018-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "MA",
            "license": "12643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica Plain, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 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.