Active NPI
Tiffanie Warzecha, OTR
- Pediatric Occupational Therapist
- Melbourne, FL
National Provider Identifier
1588968671
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- OT23699
- Practice address
- 4450 W Eau Gallie Blvd
Melbourne, FL 32934-7213 - Phone
- (321) 255-6627
- NPI assigned
- Jan 4, 2011
- Last updated
- Nov 17, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | OT 14442 | FL | |
| Pediatric Occupational Therapist | 225XP0200X | OT23699 | FL | Primary |
Addresses
Primary practice location
4450 W Eau Gallie Blvd
Melbourne, FL 32934-7213
Mailing address
469 Bimini LN
Indian Harbour Beach, FL 32937-4410
Phone (812) 589-6005
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Occupational Therapist in Private Practice
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
65 E Nasa Blvd
Suite 101
Melbourne, FL 32901-1961
Phone (321) 802-5655
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT 14442 | FL | MD | Pediatric Occupational Therapist |
| OT23699 | FL | MD | Pediatric Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Doctor of Women's Health LLC | Current | Accepting new patients |
Locations
65 E Nasa Blvd
Ste 101
Melbourne, FL 32901
Phone (321) 541-1970
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.
-
- Physical Therapist
- Melbourne, FL
- NPI 1508399619
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1294099200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1668643200000",
"number": "1588968671",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "469 BIMINI LN",
"city": "INDIAN HARBOUR BEACH",
"state": "FL",
"postal_code": "329374410",
"telephone_number": "812-589-6005"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4450 W EAU GALLIE BLVD",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329347213",
"telephone_number": "321-255-6627"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WARZECHA",
"first_name": "TIFFANIE",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-01-04",
"last_updated": "2022-11-17",
"certification_date": "2022-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "FL",
"license": "OT 14442",
"primary": false
},
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "FL",
"license": "OT23699",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Melbourne, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2022; 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.