Individual provider Active NPI

Amy Mak

  • Occupational Therapist
  • New York, NY
National Provider Identifier
1538420435
Registry record updated Jan 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
017303-1 Issued in NY
Practice address
267 Edgecombe Ave Apt 2L
New York, NY 10031-3003
Phone
(917) 589-8242
NPI assigned
Jun 6, 2012
Last updated
Jan 12, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 12, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 017303-1 NY Primary
Occupational Therapist 225X00000X 12591 CA

Addresses

Primary practice location

267 Edgecombe Ave Apt 2L
New York, NY 10031-3003

Mailing address

267 Edgecombe Ave Apt 2L
New York, NY 10031-3003
Phone (917) 589-8242

Other practice location 1

224 Elizabeth St Apt 16
New York, NY 10012-3567
Phone (917) 589-8242

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120716000346 NY Practitioner - Occupational Therapist in Private Practice 6103082318 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
017303-1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Physical and Occupational Therapy PLLC Occupational Therapist CurrentSince Jan 30, 2019 Accepting new patients
Better Yourself Rehabilitation Physical and Occupational Therapy, PLLC Occupational Therapist CurrentSince Aug 1, 2014 Accepting new patients

Locations

455 N End Ave
Bsmt
New York, NY 10282
Phone (646) 470-8615

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1338940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547251200000",
    "number": "1538420435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "267 EDGECOMBE AVE APT 2L",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100313003",
            "telephone_number": "917-589-8242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "267 EDGECOMBE AVE APT 2L",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100313003",
            "telephone_number": "917-589-8242"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "224 Elizabeth St Apt 16",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100123567",
            "country_code": "US",
            "telephone_number": "917-589-8242",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAK",
        "first_name": "AMY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-06",
        "last_updated": "2019-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "017303-1",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "12591",
            "primary": false
        }
    ],
    "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 Jan 12, 2019; 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.