Maureen Lyn Llewellyn

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

013929-01 Issued in NY

Practice address

200 W Dominick St
Rome, NY 13440-5846

Phone

(315) 339-6536

NPI assigned

Dec 15, 2022

Last updated

Dec 15, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Maureen Lyn Petrie Former name

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• State of New York Comptrollers Office

  • Developmental Disabilities Clinic/Center
  • Staten Island, NY
  • NPI 1750469912
  Medicare reassignment
• State of New York Comptrollers Office

  • Developmental Disabilities Clinic/Center
  • East Syracuse, NY
  • NPI 1114067915
  NPD

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

{
    "created_epoch": "1671062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671062400000",
    "number": "1306558812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W DOMINICK ST",
            "city": "ROME",
            "state": "NY",
            "postal_code": "134405846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W DOMINICK ST",
            "city": "ROME",
            "state": "NY",
            "postal_code": "134405846",
            "telephone_number": "315-339-6536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LLEWELLYN",
        "first_name": "MAUREEN",
        "middle_name": "LYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-15",
        "last_updated": "2022-12-15",
        "certification_date": "2022-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "013929-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAUREEN",
            "last_name": "PETRIE",
            "middle_name": "LYN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ung Kyu Lim, MD
• Lincare Inc
• Linda L. Schicker MD PLLC (Mohawk Valley Radiation Medicine)
• Lorreen Michele Lisacki, LPN
• Little Warrior
• Justin Losowski
• Jean M Lovett, SLP
• Mayle Lupia-Eannace
• Monae Lyons
• Anne Eshenour Mack

• Occupational Therapist in Rome, NY
• Providers in Rome, NY by specialty
• Occupational Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2022; 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.