Individual provider Active NPI

Gavin Marsh, OT

  • Occupational Therapist
  • Orchard Park, NY
National Provider Identifier
1780405050
Registry record updated Oct 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
029269-01 Issued in NY
Practice address
6050 Armor Duells Rd
Orchard Park, NY 14127-3126
Phone
(607) 882-0846
NPI assigned
Oct 21, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2024

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 029269-01 NY Primary

Addresses

Primary practice location

6050 Armor Duells Rd
Orchard Park, NY 14127-3126

Mailing address

812 Adams Rd
Dryden, NY 13053-9613

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241126003456 NY Practitioner - Occupational Therapist in Private Practice 2961937057 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2024
Medicare assignment
May accept Medicare assignment
Group practices
Metro Care Providers PT PLLCGroup PAC ID 2163872201, 12 clinicians

Practice addresses (Care Compare)

3670 County Rd
Geneva, NY 14456-9138
Phone (315) 789-4162

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
029269-01NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Metro Care Providers PT, PLLC CurrentSince Sep 15, 2024 Accepting new patients
Home-Based Physical Therapy PLLC Occupational Therapist PastSince Mar 4, 2020 Accepting new patients

Locations

170 Murray St
Auburn, NY 13021
Phone (315) 253-2755

6050 Armor Duells Rd
Orchard Park, NY 14127
Phone (607) 882-0846

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": "1729468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729468800000",
    "number": "1780405050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "812 ADAMS RD",
            "city": "DRYDEN",
            "state": "NY",
            "postal_code": "130539613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6050 ARMOR DUELLS RD",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141273126",
            "telephone_number": "607-882-0846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSH",
        "first_name": "GAVIN",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-10-21",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "029269-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orchard Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2024; 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.