Individual provider Active NPI

Amanda Jane Hofer

  • Physical Rehabilitation Occupational Therapist
  • Montgomery, TX
National Provider Identifier
1700186657
Registry record updated Aug 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Rehabilitation Occupational TherapistTaxonomy code 225XP0019X
License
112187 Issued in TX
Practice address
402 Moonwalk St
Montgomery, TX 77356-4715
Phone
(512) 203-2106
NPI assigned
Oct 26, 2010
Last updated
Aug 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurorehabilitation Occupational Therapist 225XN1300X 112187 TX
Physical Rehabilitation Occupational Therapist 225XP0019X 112187 TX Primary
Occupational Therapist 225X00000X 112187 TX

Addresses

Primary practice location

402 Moonwalk St
Montgomery, TX 77356-4715

Mailing address

402 Moonwalk St
Montgomery, TX 77356-4715
Phone (512) 203-2106

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110218000862 TX Practitioner - Occupational Therapist in Private Practice 2860673159 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
112187TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Beyond Barriers Therapy Solutions LLC Occupational Therapist CurrentSince Apr 10, 2024 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1288051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724976000000",
    "number": "1700186657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 MOONWALK ST",
            "city": "MONTGOMERY",
            "state": "TX",
            "postal_code": "773564715",
            "telephone_number": "512-203-2106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 MOONWALK ST",
            "city": "MONTGOMERY",
            "state": "TX",
            "postal_code": "773564715",
            "telephone_number": "512-203-2106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOFER",
        "first_name": "AMANDA",
        "middle_name": "JANE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-26",
        "last_updated": "2024-08-30",
        "certification_date": "2024-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XN1300X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Neurorehabilitation",
            "state": "TX",
            "license": "112187",
            "primary": false
        },
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "TX",
            "license": "112187",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "112187",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2024; 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.