Active NPI
Amanda Rose Jude Chruscicki, OT
- Occupational Therapist
- Westmoreland, NY
National Provider Identifier
1730781899
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 025361
- Practice address
- 5176 State Route 233
Westmoreland, NY 13490-1310 - Phone
- (315) 557-2637
- NPI assigned
- Nov 13, 2020
- Last updated
- Jan 21, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 | 025361 | NY | Primary |
Addresses
Primary practice location
5176 State Route 233
Westmoreland, NY 13490-1310
Mailing address
5176 State Route 233
Westmoreland, NY 13490-1310
Phone (315) 557-2637
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 |
|---|---|---|---|
| 025361 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1605225600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611187200000",
"number": "1730781899",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5176 STATE ROUTE 233",
"city": "WESTMORELAND",
"state": "NY",
"postal_code": "134901310",
"telephone_number": "315-557-2637"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5176 STATE ROUTE 233",
"city": "WESTMORELAND",
"state": "NY",
"postal_code": "134901310",
"telephone_number": "315-557-2637"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHRUSCICKI",
"first_name": "AMANDA",
"middle_name": "ROSE JUDE",
"credential": "OT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-11-13",
"last_updated": "2021-01-21",
"certification_date": "2021-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "025361",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Westmoreland, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.