Individual provider Active NPI

Pamela T Wadsworth, OTR

  • Occupational Therapist
  • Amsterdam, NY
National Provider Identifier
1780050880
Registry record updated Aug 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
012729-1 Issued in NY
Practice address
47 Liberty Drive
Amsterdam, NY 12010
Phone
(518) 840-5080
NPI assigned
Aug 12, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 012729-1 NY Primary

Addresses

Primary practice location

47 Liberty Drive
Amsterdam, NY 12010

Mailing address

49 Broadway
PO Box 279
Fonda, NY 12068-9000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160712000203 NY Practitioner - Occupational Therapist in Private Practice 4183916216 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nysarc Inc Montgomery County Chapter LibertyGroup PAC ID 1557651411, 12 clinicians

Practice addresses (Care Compare)

43 Liberty Dr
Amsterdam, NY 12010-5635

47 Liberty Dr
Amsterdam, NY 12010-5635
Phone (518) 842-5080

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
012729-1NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
New Dimensions in Living Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: pamelawadsworthot@synergytherapeutic.medentdirect.com

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1439337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439337600000",
    "number": "1780050880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 BROADWAY",
            "address_2": "PO BOX 279",
            "city": "FONDA",
            "state": "NY",
            "postal_code": "120689000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 LIBERTY DRIVE",
            "city": "AMSTERDAM",
            "state": "NY",
            "postal_code": "12010",
            "telephone_number": "518-840-5080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADSWORTH",
        "first_name": "PAMELA",
        "middle_name": "T",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-12",
        "last_updated": "2015-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "012729-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amsterdam, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.