Active NPI
Michaela Jean Ebert, MS, OTR/L
- Occupational Therapist
- Glens Falls, NY
National Provider Identifier
1356984587
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 028875-01
- Practice address
- 15 Quade St
Glens Falls, NY 12801-2799 - Phone
- (518) 793-5151
- NPI assigned
- Oct 21, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 010284 | NY | |
| Occupational Therapist | 225X00000X | 028875-01 | NY | Primary |
Addresses
Primary practice location
15 Quade St
Glens Falls, NY 12801-2799
Mailing address
15 Quade St
Glens Falls, NY 12801-2724
Phone (518) 792-1212
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 028875-01 | NY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1571616000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1708905600000",
"number": "1356984587",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15 QUADE ST",
"city": "GLENS FALLS",
"state": "NY",
"postal_code": "128012724",
"telephone_number": "518-792-1212"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15 QUADE ST",
"city": "GLENS FALLS",
"state": "NY",
"postal_code": "128012799",
"telephone_number": "518-793-5151"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EBERT",
"first_name": "MICHAELA",
"middle_name": "JEAN",
"credential": "MS, OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-10-21",
"last_updated": "2024-02-26",
"certification_date": "2024-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "NY",
"license": "010284",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "028875-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glens Falls, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.