Individual provider Active NPI

Brianna E. Mirenda, OT

  • Occupational Therapist
  • Leominster, MA
National Provider Identifier
1447835566
Registry record updated Jan 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
13853 Issued in MA
Practice address
225 New Lancaster Rd
Leominster, MA 01453-4958
Phone
(508) 856-9510
Fax
(508) 853-1907
NPI assigned
Mar 10, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2022

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 13853 MA Primary

Addresses

Primary practice location

225 New Lancaster Rd
Leominster, MA 01453-4958

Mailing address

225 New Lancaster Rd
Leominster, MA 01453-4958
Phone (508) 856-9510

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210520000737 MA Practitioner - Occupational Therapist in Private Practice 8224437439 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Reliant Medical Group IncGroup PAC ID 5597755322, 638 clinicians

Practice addresses (Care Compare)

225 New Lancaster Rd
Leominster, MA 01453-4958
Phone (978) 534-6500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13853MAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Reliant Medical Group, Inc CurrentSince Mar 29, 2021 Accepting new patients
Reliant Medical Group, Inc Past Accepting new patients

Locations

225 New Lancaster Rd
Leominster, MA 01453
Phone (978) 466-3208

5 Neponset St
Worcester, MA 01606
Phone (508) 595-2300

Interoperability endpoints

  • Direct secure messaging: brianna.dimattia.npi1447835566.reliant@direct.optumcare.masshiway.net

Organizations & group practices 2

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": "1615334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641945600000",
    "number": "1447835566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 NEW LANCASTER RD",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "014534958",
            "telephone_number": "508-856-9510",
            "fax_number": "508-853-1907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 NEW LANCASTER RD",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "014534958",
            "telephone_number": "508-856-9510",
            "fax_number": "508-853-1907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRENDA",
        "first_name": "BRIANNA",
        "middle_name": "E.",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-10",
        "last_updated": "2022-01-12",
        "certification_date": "2022-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MA",
            "license": "13853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leominster, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.