Individual provider Active NPI

Momota Nahar

  • Occupational Therapist
  • Chicago, IL
National Provider Identifier
1285311068
Registry record updated Jul 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056014996 Issued in IL
Practice address
1409 W Carroll Ave
Chicago, IL 60607-1105
Phone
(312) 733-0883
NPI assigned
Jul 3, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2023

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 056014996 IL Primary

Addresses

Primary practice location

1409 W Carroll Ave
Chicago, IL 60607-1105

Mailing address

1409 W Carroll Ave
Chicago, IL 60607-1105
Phone (312) 733-0883

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231102001865 MI Practitioner - Occupational Therapist in Private Practice 4688020258 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
056014996ILMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Emagine Health Services LLC Occupational Therapist CurrentSince May 15, 2025 Accepting new patients
Eyas Landing, Inc. PastSince Jul 9, 2023 Accepting new patients

Locations

6425 Schaefer Rd
Dearborn, MI 48126
Phone (313) 552-6630

Organizations & group practices 2

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": "1688342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688342400000",
    "number": "1285311068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1409 W CARROLL AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606071105",
            "telephone_number": "312-733-0883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1409 W CARROLL AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606071105",
            "telephone_number": "312-733-0883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAHAR",
        "first_name": "MOMOTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-03",
        "last_updated": "2023-07-03",
        "certification_date": "2023-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056014996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2023; 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.