Individual provider Active NPI

Amanda Van Zetta

  • Occupational Therapist
  • Danbury, CT
National Provider Identifier
1366275216
Registry record updated Aug 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5076 Issued in CT
Practice address
83 Wooster HTS Ste 125
Danbury, CT 06810-7550
Phone
(800) 613-1303
NPI assigned
Aug 24, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 023004-01 NY
Occupational Therapist 225X00000X 5076 CT Primary

Addresses

Primary practice location

83 Wooster HTS Ste 125
Danbury, CT 06810-7550

Mailing address

11 Long Hill Rd
Bethel, CT 06801-1145
Phone (914) 261-0259

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240909002149 CT Practitioner - Occupational Therapist in Private Practice 4284174954 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
023004-01NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Achieve at Home Physical Therapy PLLC CurrentSince Aug 28, 2024 Accepting new patients

Locations

83 Wooster Hts
Ste 125
Danbury, CT 06810
Phone (475) 289-7864

20 Summer St
Ste 4
Stamford, CT 06901
Phone (475) 454-4455

Organizations & group practices 1

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": "1724457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724457600000",
    "number": "1366275216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 LONG HILL RD",
            "city": "BETHEL",
            "state": "CT",
            "postal_code": "068011145",
            "telephone_number": "914-261-0259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "83 WOOSTER HTS STE 125",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068107550",
            "telephone_number": "800-613-1303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN ZETTA",
        "first_name": "AMANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-24",
        "last_updated": "2024-08-24",
        "certification_date": "2024-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "023004-01",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CT",
            "license": "5076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2024; 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.