Individual provider Active NPI

Marek Graczkowski, OTR

  • Occupational Therapist
  • Boca Raton, FL
National Provider Identifier
1649493099
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT10388 Issued in FL
Practice address
23315 Blue Water Cir
Boca Raton, FL 33433-7053
Phone
(561) 368-1033
NPI assigned
Apr 11, 2007
Sex
Male
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 OT10388 FL Primary

Addresses

Primary practice location

23315 Blue Water Cir
Boca Raton, FL 33433-7053

Mailing address

2850 Somerset Dr
L 218
Lauderdale Lakes, FL 33311-9342
Phone (954) 295-0726

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

NPI Registry JSON

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649493099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2850 SOMERSET DR",
            "address_2": "L 218",
            "city": "LAUDERDALE LAKES",
            "state": "FL",
            "postal_code": "333119342",
            "telephone_number": "954-295-0726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23315 BLUE WATER CIR",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334337053",
            "telephone_number": "561-368-1033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRACZKOWSKI",
        "first_name": "MAREK",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT10388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

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.