Individual provider Active NPI

Mario S Viegas

  • Driving and Community Mobility Occupational Therapy Assistant
  • Randolph, NJ
National Provider Identifier
1417806803
Registry record updated Oct 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Driving and Community Mobility Occupational Therapy AssistantTaxonomy code 224ZR0403X
License
V41595198204751 Issued in NJ
Practice address
1201 Sussex Tpke
Randolph, NJ 07869-2974
Phone
(201) 686-8698
NPI assigned
Jan 27, 2026
Last updated
Oct 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Driving and Community Mobility Occupational Therapy Assistant 224ZR0403X V41595198204751 NJ Primary

Addresses

Primary practice location

1201 Sussex Tpke
Randolph, NJ 07869-2974

Mailing address

9 Jacob Way
Phillipsburg, NJ 08865-2130
Phone (201) 686-8698

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
V41595198204751NJMDDriving and Community Mobility Occupational Therapy Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1769472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791849600000",
    "number": "1417806803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 JACOB WAY",
            "city": "PHILLIPSBURG",
            "state": "NJ",
            "postal_code": "088652130",
            "telephone_number": "201-686-8698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 SUSSEX TPKE",
            "city": "RANDOLPH",
            "state": "NJ",
            "postal_code": "078692974",
            "telephone_number": "201-686-8698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIEGAS",
        "first_name": "MARIO",
        "middle_name": "S",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-01-27",
        "last_updated": "2026-10-13",
        "certification_date": "2026-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224ZR0403X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant, Driving and Community Mobility",
            "state": "NJ",
            "license": "V41595198204751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Randolph, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2026; 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.