Active NPI
Kelly Pacheco Amaral
- Occupational Therapist
- Cranston, RI
National Provider Identifier
1689289209
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT01904
- Practice address
- 626 Park Ave Ste 2a
Cranston, RI 02910-2154 - Phone
- (401) 270-9991
- NPI assigned
- Sep 10, 2020
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT01904 | RI | Primary |
Addresses
Primary practice location
626 Park Ave Ste 2a
Cranston, RI 02910-2154
Mailing address
626 Park Ave Ste 2a
Cranston, RI 02910-2154
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0163744043 | Medicaid | RI |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | OT@cbstherapy.com |
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
| License | State | Type | Specialty |
|---|---|---|---|
| OT01904 | RI | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Acme Therapy Holdings Inc | Occupational Therapist | Past | Accepting new patients |
| CBS Therapy | Occupational Therapist | Past | Accepting new patients |
Interoperability endpoints
- ot@cbstherapy.com
Organizations & group practices 2
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.
-
- Physical Therapist
- North Andover, MA
- NPI 1407522634
Occupational Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1599696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1648425600000",
"number": "1689289209",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "626 PARK AVE STE 2A",
"city": "CRANSTON",
"state": "RI",
"postal_code": "029102154"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "626 PARK AVE STE 2A",
"city": "CRANSTON",
"state": "RI",
"postal_code": "029102154",
"telephone_number": "401-270-9991"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AMARAL",
"first_name": "KELLY",
"middle_name": "PACHECO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-09-10",
"last_updated": "2022-03-28",
"certification_date": "2022-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "RI",
"license": "OT01904",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0163744043",
"state": "RI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "OT@cbstherapy.com",
"affiliation": "N",
"endpointDescription": "work email",
"address_1": "626 Park Ave Ste 2A",
"city": "Cranston",
"state": "RI",
"country_code": "US",
"postal_code": "029102154",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Cranston, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.