Individual provider Active NPI

Mariela Isabel Haymes, OTR/L

  • Occupational Therapist
  • Brooklyn, NY
National Provider Identifier
1417766825
Registry record updated Jan 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
029766 Issued in NY
Practice address
1317 Avenue J FL 2
Brooklyn, NY 11230-3605
Phone
(718) 814-7200
NPI assigned
Jan 1, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 1, 2025

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 029766 NY Primary

Addresses

Primary practice location

1317 Avenue J FL 2
Brooklyn, NY 11230-3605

Mailing address

173 Beacon Ave
Staten Island, NY 10306-1324
Phone (347) 782-2763

Other practice location 1

173 Beacon Ave
Staten Island, NY 10306-1324
Phone (347) 782-2763

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
029766NYMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1735689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735689600000",
    "number": "1417766825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "173 BEACON AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103061324",
            "telephone_number": "347-782-2763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1317 AVENUE J FL 2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112303605",
            "telephone_number": "718-814-7200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "173 Beacon Ave",
            "address_purpose": "LOCATION",
            "city": "Staten Island",
            "state": "NY",
            "postal_code": "103061324",
            "country_code": "US",
            "telephone_number": "347-782-2763",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAYMES",
        "first_name": "MARIELA",
        "middle_name": "ISABEL",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-01",
        "last_updated": "2025-01-01",
        "certification_date": "2025-01-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "029766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 1, 2025; 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.