Individual provider Active NPI

Samantha Struzyk, OTR/L

  • Occupational Therapist
  • Raleigh, NC
National Provider Identifier
1568927382
Registry record updated Feb 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
7953 Issued in NC
Practice address
4011 Westchase Blvd Ste 290
Raleigh, NC 27607-3954
Phone
(919) 785-9090
NPI assigned
Feb 6, 2019
Last updated
Feb 6, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 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 7953 NC Primary

Addresses

Primary practice location

4011 Westchase Blvd Ste 290
Raleigh, NC 27607-3954

Mailing address

4011 Westchase Blvd Ste 290
Raleigh, NC 27607-3954
Phone (919) 785-9090

Other identifiers 1

IdentifierTypeStateIssuer
7953OtherNCNCBOT

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190312002342 NC Practitioner - Occupational Therapist in Private Practice 3779823679 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Active at Home Senior ServicesGroup PAC ID 8224424551, 3 clinicians

Practice addresses (Care Compare)

3523 Courtland Dr
Durham, NC 27707-5134
Phone (919) 605-6105

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7953NCMDOrthodontics and Dentofacial Orthopedic Dentist
7593NCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Active at Home Senior Services Occupational Therapist CurrentSince Apr 1, 2023 Accepting new patients

Locations

4711 Hope Valley Rd
Ste 4F417
Durham, NC 27707

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, 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": "1549411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549411200000",
    "number": "1568927382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4011 WESTCHASE BLVD STE 290",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276073954",
            "telephone_number": "919-785-9090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4011 WESTCHASE BLVD STE 290",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276073954",
            "telephone_number": "919-785-9090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STRUZYK",
        "first_name": "SAMANTHA",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-06",
        "last_updated": "2019-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "7953",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCBOT",
            "identifier": "7953",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.