Maya Helen Herzog, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT60926626 Issued in WA

Practice address

4636 E Marginal Way S Ste B100
Seattle, WA 98134-2322

Phone

(206) 763-0352

NPI assigned

Feb 5, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Lighthouse for the Blind, Inc

  dba Lighthouse Low Vision Clinic

  • Low Vision Rehabilitation Optometrist
  • Seattle, WA
  • NPI 1205478559
  Medicare reassignment NPD

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

{
    "created_epoch": "1549324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549324800000",
    "number": "1629533526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4907 37TH AVE S",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981181720",
            "telephone_number": "917-517-9036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4636 E MARGINAL WAY S STE B100",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981342322",
            "telephone_number": "206-763-0352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERZOG",
        "first_name": "MAYA",
        "middle_name": "HELEN",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-05",
        "last_updated": "2019-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WA",
            "license": "OT60926626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eleanor Herting
• Julie Hertl, LICSW
• Elizabeth Hertz-Wahl, RN
• Lerin E Herzer, LMHCA
• Hannah Herzfeld
• Scott Douglas Herzog, PHARM D
• Fred S. Herzon, M.D.
• Kelly Ahern Heshelman
• Mitra Heshmati, M.D., PH.D.
• Elizabeth Lydia Hess

• Occupational Therapist in Seattle, WA
• Providers in Seattle, WA by specialty
• Occupational Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2019; 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.