Desirae Marie Laporta, OTR/L

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

OT-2169 Issued in ID

Practice address

2419 E Massachusetts Ave
Nampa, ID 83686-6295

Phone

(916) 749-8260

NPI assigned

Jun 10, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Mrs. Desirae Marie Hyde Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1623283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695945600000",
    "number": "1629645205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3086 W MILANO DRIVE",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "83646",
            "telephone_number": "208-996-0552",
            "fax_number": "208-914-6597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2419 E MASSACHUSETTS AVE",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836866295",
            "telephone_number": "916-749-8260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAPORTA",
        "first_name": "DESIRAE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-10",
        "last_updated": "2023-09-29",
        "certification_date": "2021-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "ID",
            "license": "OT-2169",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "ID",
            "license": "OT-2169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DESIRAE",
            "last_name": "HYDE",
            "middle_name": "MARIE",
            "prefix": "MRS.",
            "credential": "OTR/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kjersti Lang
• George Langfield, PH.D
• Jasmine Emma Laniado
• Conner Lanier, PA
• Brenna Joy Lankow
• Meredith A Larsen, DO
• Matthew Larson, LCSW
• Vicki J Larson
• Madelena Larue
• Bari Laskow, MD

• Pediatric Occupational Therapist in Nampa, ID
• Providers in Nampa, ID by specialty
• Pediatric Occupational Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2023; 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.