Individual provider Active NPI

Judy A Stegenga, O.T.R.

  • Occupational Therapist
  • Lynn, MA
National Provider Identifier
1609097609
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
3139 Issued in MA
Practice address
103 Johnson St
Lynn, MA 01902-4001
Phone
(781) 593-2727
Fax
(781) 593-2542
NPI assigned
May 1, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 3139 MA Primary

Addresses

Primary practice location

103 Johnson St
Lynn, MA 01902-4001

Mailing address

23 The Greenway
Swampscott, MA 01907-1107
Phone (978) 744-7037

Other names 1

  • Judy Ustasiewski Former name

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

LicenseStateTypeSpecialty
3139MAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609097609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 THE GREENWAY",
            "city": "SWAMPSCOTT",
            "state": "MA",
            "postal_code": "019071107",
            "telephone_number": "978-744-7037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 JOHNSON ST",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019024001",
            "telephone_number": "781-593-2727",
            "fax_number": "781-593-2542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEGENGA",
        "first_name": "JUDY",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "O.T.R.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MA",
            "license": "3139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JUDY",
            "last_name": "USTASIEWSKI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lynn, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.