Amanda Marie Lubas, OTR/L
Individual provider Active NPI Pediatric Occupational Therapist · Beverly, MA
NPI 1720120736 · NPPES record last updated Dec 3, 2019
Key facts
- NPI
- 1720120736
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Occupational Therapist 225XP0200X
- License
- 8294 (MA)
- Practice address
- 260 Cabot St
Beverly, MA 01915 - Phone
- (978) 535-6043
- Fax
- (978) 535-6047
- NPI assigned
- Feb 13, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Occupational Therapist in Private Practice
- Education
- Other, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
260 Cabot St
Beverly, MA 01915-4523
Phone (978) 304-4791
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060410000458 | MA | Practitioner - Occupational Therapist in Private Practice | 1153338314 |
Reassigns benefits to 1 organization Practice locations: Beverly, MA |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1668 | NH | MD | Veterinarian |
| 8294 | MA | MD | Oral & Maxillofacial Surgery (D.M.D.) |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Holistic Therapies 4 Life Corps | Current |
Accepting new patients | |
| Excella Healthcare, Inc. | Past | Accepting new patients |
Locations
260 Cabot St
Beverly, MA 01915
Phone (978) 304-4791
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | 8294 | MA | Yes |
Addresses
Primary practice location
260 Cabot St
Beverly, MA 01915
Mailing address
260 Cabot St
Beverly, MA 01915
Phone (978) 535-6043
Other providers in Beverly, MA
- Stephen Russell Loverme Jr.
- Rachel Lovett
- Erica Lowder
- Kenneth Evan Lowell
- Elizabeth Loy
- Sarah Lubofsky
- Barbara J Luby
- Pamela E Lucci
- Ivana Lucero
- Jennifer Lucich
All providers in Beverly, MA · Pediatric Occupational Therapist in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 3, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.