Active NPI
Michelle Bodensieck
- Occupational Therapist
- Goshen, NY
National Provider Identifier
1417525866
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 024618-01
- Practice address
- 2 Glenmere Cove Rd
Goshen, NY 10924-6059 - Phone
- (845) 291-4112
- NPI assigned
- Jun 13, 2021
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 024618-01 | NY | Primary |
Addresses
Primary practice location
2 Glenmere Cove Rd
Goshen, NY 10924-6059
Mailing address
214 Last Rd
Middletown, NY 10941-5021
Phone (845) 978-3573
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
| License | State | Type | Specialty |
|---|---|---|---|
| 024618-01 | NY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1623542400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623542400000",
"number": "1417525866",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "214 LAST RD",
"city": "MIDDLETOWN",
"state": "NY",
"postal_code": "109415021",
"telephone_number": "845-978-3573"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 GLENMERE COVE RD",
"city": "GOSHEN",
"state": "NY",
"postal_code": "109246059",
"telephone_number": "845-291-4112"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BODENSIECK",
"first_name": "MICHELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-06-13",
"last_updated": "2021-06-13",
"certification_date": "2021-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "024618-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Goshen, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.