Active NPI
Alyse Daniele Wood, OTRL
- Occupational Therapist
- Crown Point, IN
National Provider Identifier
1346890936
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 31006866A
- Practice address
- 10215 Broadway
Crown Point, IN 46307-8001 - Phone
- (219) 663-8948
- NPI assigned
- Sep 16, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 31006866A | IN | Primary |
Addresses
Primary practice location
10215 Broadway
Crown Point, IN 46307-8001
Mailing address
6340 E Main St Apt 301
Portage, IN 46368-4680
Phone (989) 292-9634
Other practice location 1
901 MacArthur Blvd
Munster, IN 46321-2901
Phone (219) 836-4527
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20191031001832 | IN | Practitioner - Occupational Therapist in Private Practice | 4789916370 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31006866A | IN | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Munster Radiology Group PC | Past | Accepting new patients |
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.
-
- Diagnostic Radiology Physician
- Munster, IN
- NPI 1144207101
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1568592000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1568592000000",
"number": "1346890936",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6340 E MAIN ST APT 301",
"city": "PORTAGE",
"state": "IN",
"postal_code": "463684680",
"telephone_number": "989-292-9634"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10215 BROADWAY",
"city": "CROWN POINT",
"state": "IN",
"postal_code": "463078001",
"telephone_number": "219-663-8948"
}
],
"practiceLocations": [
{
"address_1": "901 MacArthur Blvd",
"address_purpose": "LOCATION",
"city": "Munster",
"state": "IN",
"postal_code": "463212901",
"country_code": "US",
"telephone_number": "219-836-4527",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WOOD",
"first_name": "ALYSE",
"middle_name": "DANIELE",
"credential": "OTRL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-09-16",
"last_updated": "2019-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IN",
"license": "31006866A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Crown Point, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2019; 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.