Individual provider Active NPI

Mary Joyce Tagatac

  • Occupational Therapy Assistant
  • Flushing, NY
National Provider Identifier
1700486131
Registry record updated Oct 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
009842 Issued in NY
Practice address
13966 35TH Ave
Flushing, NY 11354-3524
Phone
(718) 961-5300
NPI assigned
Oct 26, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 009842 NY Primary

Addresses

Primary practice location

13966 35TH Ave
Flushing, NY 11354-3524

Mailing address

8950 56TH Ave Apt 6P
Elmhurst, NY 11373-4906
Phone (917) 214-9980

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": "1603670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603670400000",
    "number": "1700486131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8950 56TH AVE APT 6P",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113734906",
            "telephone_number": "917-214-9980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13966 35TH AVE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113543524",
            "telephone_number": "718-961-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAGATAC",
        "first_name": "MARY JOYCE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-26",
        "last_updated": "2020-10-26",
        "certification_date": "2020-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NY",
            "license": "009842",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2020; 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.