Active NPI
Melissa Berutto
- Occupational Therapy Assistant
- Glendale, AZ
National Provider Identifier
1558732131
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 6110
- Practice address
- 5236 W Peoria Ave Apt 238
Glendale, AZ 85302-1624 - Phone
- (602) 575-4385
- NPI assigned
- Oct 8, 2015
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 6110 | AZ | Primary |
Addresses
Primary practice location
5236 W Peoria Ave Apt 238
Glendale, AZ 85302-1624
Mailing address
8724 W Windsor Dr
Peoria, AZ 85381-5114
Phone (602) 575-4385
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6110 | AZ | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1444262400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1492128000000",
"number": "1558732131",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8724 W WINDSOR DR",
"city": "PEORIA",
"state": "AZ",
"postal_code": "853815114",
"telephone_number": "602-575-4385"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5236 W PEORIA AVE APT 238",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853021624",
"telephone_number": "602-575-4385"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERUTTO",
"first_name": "MELISSA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-10-08",
"last_updated": "2017-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "AZ",
"license": "6110",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glendale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.