Jaemey T Matherly, OTR/L

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

OTH-009522 Issued in AZ

Practice address

11224 E Raleigh Ave
Mesa, AZ 85212-4061

Phone

(480) 528-9978

NPI assigned

Feb 8, 2024

Last updated

Feb 8, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Amy Grulke PLLCGroup PAC ID 4284992538, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Amy Grulke, PLLC

  dba Arbor Therapy

  • Speech-Language Pathologist
  • Chandler, AZ
  • NPI 1316464795

  Occupational Therapist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1707350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707350400000",
    "number": "1366206559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11224 E RALEIGH AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852124061",
            "telephone_number": "480-528-9978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11224 E RALEIGH AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852124061",
            "telephone_number": "480-528-9978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHERLY",
        "first_name": "JAEMEY",
        "middle_name": "T",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-02-08",
        "last_updated": "2024-02-08",
        "certification_date": "2024-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AZ",
            "license": "OTH-009522",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "AZ",
            "license": "OTH-009522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristian Jay Mastin, MC, LAC
• Morgan Leigh Mastromarino
• Kevin Masur, M.D.
• Kelsey Matarese
• Maternal Fetal Medicine of Arizona LLC
• Mary Matherly
• Gina Marie Mathew, MD
• Amanda Marie Mathews, LPC
• Brandon Mathews, DC
• Terry Mathews, LPC

• Pediatric Occupational Therapist in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Pediatric Occupational Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2024; 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.