Individual provider Active NPI

John Samaniego, OTR

  • Occupational Therapist
  • San Benito, TX
National Provider Identifier
1851936884
Registry record updated Nov 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
120004 Issued in TX
Practice address
1145 Ross St Ste E
San Benito, TX 78586-4338
Phone
(956) 361-6000
Fax
(956) 361-6060
NPI assigned
Nov 13, 2019
Last updated
Nov 13, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2019

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 120004 TX Primary

Addresses

Primary practice location

1145 Ross St Ste E
San Benito, TX 78586-4338

Mailing address

2901 Haine Dr Apt 1007
Harlingen, TX 78550-7816
Phone (956) 454-6803

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260604000795 NY Practitioner - Occupational Therapist in Private Practice 6002387669 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

171 Kings Hwy
Brooklyn, NY 11223

171 Kings Hwy
Brooklyn, NY 11223-1023

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
120004TXMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Rehab Services Inc Occupational Therapist PastSince Nov 17, 2019 Accepting new patients

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, 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": "1573603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573603200000",
    "number": "1851936884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 HAINE DR APT 1007",
            "city": "HARLINGEN",
            "state": "TX",
            "postal_code": "785507816",
            "telephone_number": "956-454-6803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1145 ROSS ST STE E",
            "city": "SAN BENITO",
            "state": "TX",
            "postal_code": "785864338",
            "telephone_number": "956-361-6000",
            "fax_number": "956-361-6060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMANIEGO",
        "first_name": "JOHN",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-11-13",
        "last_updated": "2019-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "120004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Benito, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2019; 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.