Individual provider Active NPI

Michelle L Odonnell, OTR

  • Occupational Therapist
  • Ballston Spa, NY
National Provider Identifier
1326703182
Registry record updated Nov 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
006907-01 Issued in NY
Practice address
Home of the Good Shepard
26 Rockrose Way
Ballston Spa, NY 12020
Phone
(518) 581-2800
NPI assigned
Nov 5, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225X00000X 006907-01 NY Primary

Addresses

Primary practice location

Home of the Good Shepard
26 Rockrose Way
Ballston Spa, NY 12020

Mailing address

203 Drummond Dr
Ballston Spa, NY 12020-3749
Phone (518) 226-2120

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211220000479 NY Practitioner - Occupational Therapist in Private Practice 1557751088 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

131 Lawrence St
Saratoga Springs, NY 12866-1346
Phone (631) 467-3700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
006907-01NYMDOccupational Therapist
006907NYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
PRN Physical, Occupational and Speech Therapy Network, PLLC CurrentSince Nov 1, 2021 Accepting new patients
PRN Physical, Occupational and Speech Therapy Network, PLLC Single Specialty CurrentSince Nov 1, 2021 Accepting new patients

Locations

20 Peachtree Ct
Ste 105
Holbrook, NY 11741
Phone (518) 253-4983

131 Lawrence St
Saratoga Springs, NY 12866
Phone (518) 587-3600

2222 Sullivan Trl
Ste 105
Easton, PA 18040
Phone (574) 261-7058

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": "1636070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636070400000",
    "number": "1326703182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 DRUMMOND DR",
            "city": "BALLSTON SPA",
            "state": "NY",
            "postal_code": "120203749",
            "telephone_number": "518-226-2120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HOME OF THE GOOD SHEPARD",
            "address_2": "26 ROCKROSE WAY",
            "city": "BALLSTON SPA",
            "state": "NY",
            "postal_code": "12020",
            "telephone_number": "518-581-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODONNELL",
        "first_name": "MICHELLE",
        "middle_name": "L",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-05",
        "last_updated": "2021-11-05",
        "certification_date": "2021-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "006907-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ballston Spa, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.