Mary E Vanesko, MOT, OTR-L, CIMI

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

OC010598 Issued in PA

Practice address

311 Wyoming Ave
Wyoming, PA 18644-1620

Phone

(570) 336-0309

Fax

(272) 207-2774

NPI assigned

Sep 10, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Well-Nurtured Development

  • Pediatric Occupational Therapist
  • Kingston, PA
  • NPI 1952994659
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1347235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733356800000",
    "number": "1467702126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 WYOMING AVE",
            "city": "WYOMING",
            "state": "PA",
            "postal_code": "186441620",
            "telephone_number": "570-336-0309",
            "fax_number": "272-207-2774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 WYOMING AVE",
            "city": "WYOMING",
            "state": "PA",
            "postal_code": "186441620",
            "telephone_number": "570-336-0309",
            "fax_number": "272-207-2774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANESKO",
        "first_name": "MARY",
        "middle_name": "E",
        "name_prefix": "Miss",
        "credential": "MOT, OTR-L, CIMI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-10",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "PA",
            "license": "OC010598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allison Stallard, OTR-L
• Louise A Stark, REGISTERED NURSE
• Toni Jo Parmelee, D.O., PC
• Twardowski Counseling LLC
• Thomas Mark Twardowski, LCSW
• Webb Chiropractic Center
• Philip P Webb, DC
• Tiffany Alexa Webb, DC
• William R Seitzinger
• Kelly S Williams, D.M.D.

• Pediatric Occupational Therapist in Wyoming, PA
• Providers in Wyoming, PA by specialty
• Pediatric Occupational Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.