Individual provider Active NPI

Melissa A Hysick, OTR/L

  • Occupational Therapist
  • Syracuse, NY
National Provider Identifier
1255625893
Registry record updated May 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
011034-1 Issued in NY
Practice address
1744 W Genesee St
Syracuse, NY 13204-1902
Phone
(315) 468-3414
NPI assigned
May 31, 2011
Last updated
May 31, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2011

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 011034-1 NY Primary

Addresses

Primary practice location

1744 W Genesee St
Syracuse, NY 13204-1902

Mailing address

3648 Whispering Woods Ter
Baldwinsville, NY 13027-8306
Phone (315) 652-6816

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
011034-1NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1306800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306800000000",
    "number": "1255625893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3648 WHISPERING WOODS TER",
            "city": "BALDWINSVILLE",
            "state": "NY",
            "postal_code": "130278306",
            "telephone_number": "315-652-6816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1744 W GENESEE ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132041902",
            "telephone_number": "315-468-3414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HYSICK",
        "first_name": "MELISSA",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-31",
        "last_updated": "2011-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "011034-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2011; 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.