Active NPI
Michael Alan Zimmerman, MS, OTR/L
- Pediatric Occupational Therapist
- Milford, PA
National Provider Identifier
1528391620
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- OC007256L
- Practice address
- 101 Pocono Dr Ste 2And3
Milford, PA 18337-9408 - Phone
- (570) 296-3992
- NPI assigned
- Sep 8, 2009
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | OC007256L | PA | Primary |
Addresses
Primary practice location
101 Pocono Dr Ste 2And3
Milford, PA 18337-9408
Mailing address
101 Pocono Dr Ste 2And3
Milford, PA 18337-9408
Phone (570) 296-3992
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0019468450002 | Medicaid | PA |
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OC007256L | PA | MD | Pediatric Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Center for Developmental Disabilities of Pike County | Past | Accepting new patients |
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.
-
- Early Intervention Provider Agency
- Milford, PA
- NPI 1134308570
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1252368000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1252368000000",
"number": "1528391620",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 POCONO DR STE 2AND3",
"city": "MILFORD",
"state": "PA",
"postal_code": "183379408",
"telephone_number": "570-296-3992"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 POCONO DR STE 2AND3",
"city": "MILFORD",
"state": "PA",
"postal_code": "183379408",
"telephone_number": "570-296-3992"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZIMMERMAN",
"first_name": "MICHAEL",
"middle_name": "ALAN",
"name_prefix": "Mr.",
"credential": "MS, OTR/L",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-09-08",
"last_updated": "2009-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "PA",
"license": "OC007256L",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0019468450002",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Milford, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.