Individual provider Active NPI

Malachi Jacoby Segura, OTR/L

  • Occupational Therapist
  • Albuquerque, NM
National Provider Identifier
1407428303
Registry record updated Oct 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT-2023-0089 Issued in NM
Practice address
3311 Candelaria Rd NE Ste E
Albuquerque, NM 87107-1952
Phone
(505) 200-9962
NPI assigned
Jul 12, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT-2023-0089 NM Primary

Addresses

Primary practice location

3311 Candelaria Rd NE Ste E
Albuquerque, NM 87107-1952

Mailing address

11317 Baja Dr NE
Albuquerque, NM 87111-2609
Phone (505) 429-8841

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

State licenses

LicenseStateTypeSpecialty
OT-2023-0089NMMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
We Need to Talk and More LLC PastSince Oct 13, 2024 Accepting new patients

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": "1626048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728259200000",
    "number": "1407428303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11317 BAJA DR NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871112609",
            "telephone_number": "505-429-8841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3311 CANDELARIA RD NE STE E",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871071952",
            "telephone_number": "505-200-9962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEGURA",
        "first_name": "MALACHI",
        "middle_name": "JACOBY",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-07-12",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NM",
            "license": "OT-2023-0089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 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.

Verify at the official NPI Registry.