Active NPI
Amanda Marie Mondrick, OTR/L
- Occupational Therapist
- Utica, NY
National Provider Identifier
1467738575
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 017060-1
- Practice address
- 106 Memorial Pkwy
Utica, NY 13501-4818 - Phone
- (315) 792-2163
- NPI assigned
- Nov 2, 2011
- 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 | 017060-1 | NY | Primary |
Addresses
Primary practice location
106 Memorial Pkwy
Utica, NY 13501-4818
Mailing address
1403 Albany St
Utica, NY 13501-4233
Phone (315) 404-8600
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 |
|---|---|---|---|
| 017060-1 | NY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1320192000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320192000000",
"number": "1467738575",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1403 ALBANY ST",
"city": "UTICA",
"state": "NY",
"postal_code": "135014233",
"telephone_number": "315-404-8600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "106 MEMORIAL PKWY",
"city": "UTICA",
"state": "NY",
"postal_code": "135014818",
"telephone_number": "315-792-2163"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MONDRICK",
"first_name": "AMANDA",
"middle_name": "MARIE",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-11-02",
"last_updated": "2011-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "017060-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Utica, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.