Individual provider Active NPI

Max Shayne Pancer

  • Occupational Therapist
  • New York, NY
National Provider Identifier
1487215265
Registry record updated Jun 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
023547-1 Issued in NY
Practice address
251 W 154TH St
New York, NY 10039-1725
Phone
(646) 625-5000
NPI assigned
Jun 24, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2019

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 023547-1 NY Primary

Addresses

Primary practice location

251 W 154TH St
New York, NY 10039-1725

Mailing address

1598 3Rd Ave
New York, NY 10128-4330
Phone (347) 981-7550

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
023547-1NYMDOccupational Therapist

Interoperability endpoints

  • Direct secure messaging: max.pancer.p2@direct.ucpnyc.nextgenshare.com

NPI Registry JSON

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

{
    "created_epoch": "1561334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561334400000",
    "number": "1487215265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1598 3RD AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101284330",
            "telephone_number": "347-981-7550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 W 154TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100391725",
            "telephone_number": "646-625-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANCER",
        "first_name": "MAX",
        "middle_name": "SHAYNE",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-24",
        "last_updated": "2019-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "023547-1",
            "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 Jun 24, 2019; 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.