Individual provider Active NPI

Cody Lukasik

  • Pediatric Occupational Therapist
  • Wellesley Hills, MA
National Provider Identifier
1760916001
Registry record updated Apr 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
12433 Issued in MA
Practice address
396 Washington St Ste 227
Wellesley Hills, MA 02481-6209
Phone
(781) 514-5673
NPI assigned
Apr 13, 2017
Last updated
Apr 17, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 12433 MA Primary

Addresses

Primary practice location

396 Washington St Ste 227
Wellesley Hills, MA 02481-6209

Mailing address

396 Washington St Ste 227
Wellesley Hills, MA 02481-6209
Phone (781) 514-5673

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

LicenseStateTypeSpecialty
12433MAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Emerging Kids Pediatric Occupational Therapy Pediatrics Current Accepting new patients

Locations

396 Washington St
Wellesley Hills, MA 02481
Phone (781) 514-5673

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": "1492041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713312000000",
    "number": "1760916001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "396 WASHINGTON ST STE 227",
            "city": "WELLESLEY HILLS",
            "state": "MA",
            "postal_code": "024816209",
            "telephone_number": "781-514-5673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "396 WASHINGTON ST STE 227",
            "city": "WELLESLEY HILLS",
            "state": "MA",
            "postal_code": "024816209",
            "telephone_number": "781-514-5673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUKASIK",
        "first_name": "CODY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-13",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "MA",
            "license": "12433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellesley Hills, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2024; 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.