Individual provider Active NPI

Martina Marie Balas, OTR/L

  • Occupational Therapist
  • East Aurora, NY
National Provider Identifier
1265709984
Registry record updated Nov 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
004573-1 Issued in NY
Practice address
1010 Center Rd
East Aurora, NY 14052-3009
Phone
(716) 652-8250
Fax
(716) 655-3675
NPI assigned
Nov 23, 2011
Last updated
Nov 23, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2011

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 004573-1 NY Primary
Pediatric Occupational Therapist 225XP0200X 004573-1 NY
Gerontology Occupational Therapist 225XG0600X 004573-1 NY
Physical Rehabilitation Occupational Therapist 225XP0019X 004573-1 NY

Addresses

Primary practice location

1010 Center Rd
East Aurora, NY 14052-3009

Mailing address

8685 Erie Rd
Angola, NY 14006-9620
Phone (716) 549-4454

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
004573-1NYMDPhysical Rehabilitation Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1322006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322006400000",
    "number": "1265709984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8685 ERIE RD",
            "city": "ANGOLA",
            "state": "NY",
            "postal_code": "140069620",
            "telephone_number": "716-549-4454",
            "fax_number": "716-549-5181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 CENTER RD",
            "city": "EAST AURORA",
            "state": "NY",
            "postal_code": "140523009",
            "telephone_number": "716-652-8250",
            "fax_number": "716-655-3675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALAS",
        "first_name": "MARTINA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-23",
        "last_updated": "2011-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "004573-1",
            "primary": true
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NY",
            "license": "004573-1",
            "primary": false
        },
        {
            "code": "225XG0600X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Gerontology",
            "state": "NY",
            "license": "004573-1",
            "primary": false
        },
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "NY",
            "license": "004573-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Aurora, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 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.