Individual provider Active NPI

Jamie Lauren Maxwell

  • Occupational Therapist
  • New York, NY
National Provider Identifier
1477069128
Registry record updated Mar 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
0220111 Issued in NY
Practice address
442 E Houston St
New York, NY 10002-1122
Phone
(212) 677-5710
NPI assigned
Dec 18, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225X00000X 0220111 NY Primary

Addresses

Primary practice location

442 E Houston St
New York, NY 10002-1122

Mailing address

501 Oxford Rd
Cedarhurst, NY 11516-1138
Phone (516) 554-4064

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180530001225 NY Practitioner - Occupational Therapist in Private Practice 2769747443 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Shield of David, Inc.Group PAC ID 2264472026, 15 clinicians

Practice addresses (Care Compare)

14461 Roosevelt Ave
Flushing, NY 11354-6252
Phone 71893987001311

3909 214TH PL
Bayside, NY 11361-2123
Phone 71822957572289

4234 Vireo Ave
FL 2
Bronx, NY 10470-2412
Phone 71893987001311

The Shield Institute
Flushing, NY 11354-6252

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0220111NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The Shield of David, Inc. Single Specialty CurrentSince Apr 1, 2018 Accepting new patients

Locations

3909 214th Pl
Flushing, NY 11361
Phone (718) 229-5757

14461 Roosevelt Ave
Flushing, NY 11354
Phone (718) 886-1534

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1513555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741132800000",
    "number": "1477069128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 OXFORD RD",
            "city": "CEDARHURST",
            "state": "NY",
            "postal_code": "115161138",
            "telephone_number": "516-554-4064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "442 E HOUSTON ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100021122",
            "telephone_number": "212-677-5710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAXWELL",
        "first_name": "JAMIE",
        "middle_name": "LAUREN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-18",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "0220111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2025; 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.