Individual provider Active NPI

Andrea Nicole Zyla, OTR/L

  • Occupational Therapist
  • Bellevue, NE
National Provider Identifier
1558184390
Registry record updated Oct 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
2968 Issued in NE
Practice address
1001 Fort Crook Rd N Ste 202
Bellevue, NE 68005-4226
Phone
(402) 763-4408
Fax
(402) 343-1278
NPI assigned
Oct 31, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2024

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 2968 NE Primary

Addresses

Primary practice location

1001 Fort Crook Rd N Ste 202
Bellevue, NE 68005-4226

Mailing address

10909 Mill Valley Rd Ste 210
Omaha, NE 68154-3950
Phone (402) 391-5002

Other names 1

  • Andrea Nicole Wolf Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241112000980 NE Practitioner - Occupational Therapist in Private Practice 8022542166 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Maxability Therapy Services, P.C. Occupational Therapist CurrentSince Oct 22, 2024 Accepting new patients

Locations

1001 Fort Crook Rd N
Ste 202
Bellevue, NE 68005
Phone (402) 391-5002

10909 Mill Valley Rd
Ste 210
Omaha, NE 68154
Phone (402) 391-5002

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": "1730332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730332800000",
    "number": "1558184390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10909 MILL VALLEY RD STE 210",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681543950",
            "telephone_number": "402-391-5002",
            "fax_number": "402-343-1278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 FORT CROOK RD N STE 202",
            "city": "BELLEVUE",
            "state": "NE",
            "postal_code": "680054226",
            "telephone_number": "402-763-4408",
            "fax_number": "402-343-1278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZYLA",
        "first_name": "ANDREA",
        "middle_name": "NICOLE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-31",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NE",
            "license": "2968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "WOLF",
            "middle_name": "NICOLE",
            "credential": "OTR/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bellevue, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2024; 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.