Individual provider Active NPI

Michelle L Wirtenson, OTR/L

  • Occupational Therapist
  • N Massapequa, NY
National Provider Identifier
1407957921
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
007153 Issued in NY
Practice address
231 N Wisconsin Ave
N Massapequa, NY 11758-1736
Phone
(516) 395-4271
Fax
(516) 420-5539
NPI assigned
Sep 26, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 007153 NY Primary

Addresses

Primary practice location

231 N Wisconsin Ave
N Massapequa, NY 11758-1736

Mailing address

231 N Wisconsin Ave
N Massapequa, NY 11758-1736
Phone (516) 395-4271

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
007153NYMDMental Health Counselor

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407957921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "231 N WISCONSIN AVE",
            "city": "N MASSAPEQUA",
            "state": "NY",
            "postal_code": "117581736",
            "telephone_number": "516-395-4271",
            "fax_number": "516-420-5539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "231 N WISCONSIN AVE",
            "city": "N MASSAPEQUA",
            "state": "NY",
            "postal_code": "117581736",
            "telephone_number": "516-395-4271",
            "fax_number": "516-420-5539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIRTENSON",
        "first_name": "MICHELLE",
        "middle_name": "L",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "007153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in N Massapequa, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.