NPIMap

Organization Active NPI

Melissa Clark OT PLLC

  • Occupational Therapist
  • Rochester, NY
National Provider Identifier
1265132567
Registry record updated Nov 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Legal business name
MELISSA CLARK OT PLLC
Practice address
1200 Jefferson Rd Ste 110
Rochester, NY 14623-3158
Phone
(585) 363-5255
Fax
(585) 282-0086
NPI assigned
Mar 6, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2025

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

Authorized official

Name
Mrs. Melissa Clark, MS COTNPI 1215574892
Title
Owner
Phone
(585) 749-4670

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225X00000X Primary

Addresses

Primary practice location

1200 Jefferson Rd Ste 110
Rochester, NY 14623-3158

Mailing address

21 Sunberry Dr
Penfield, NY 14526-2836
Phone (585) 749-4670

Other names 1

  • Clark Cancer & Lymphedema Therapy Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230427002348 NY Part B Supplier - Physical/Occupational Therapy Group in Private Practice 4385009265 Receives reassigned benefits from 1 practitioner
Practice locations: Rochester, NY

National Provider Directory

National Provider Directory

Locations

43 Willow Pond Way
Ste 101
Penfield, NY 14526
Phone (585) 201-8524

1200 Jefferson Rd
Ste 110
Rochester, NY 14623
Phone (585) 363-5255

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1678060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762992000000",
    "number": "1265132567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 SUNBERRY DR",
            "city": "PENFIELD",
            "state": "NY",
            "postal_code": "145262836",
            "telephone_number": "585-749-4670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 JEFFERSON RD STE 110",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146233158",
            "telephone_number": "585-363-5255",
            "fax_number": "585-282-0086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MELISSA CLARK OT PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-06",
        "last_updated": "2025-11-13",
        "certification_date": "2025-11-13",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "585-749-4670",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MS COT"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clark Cancer & Lymphedema Therapy",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Clark Cancer & Lymphedema Therapy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.