Active NPI
Marissa Montamat, COTA
- Occupational Therapy Assistant
- Boise, ID
National Provider Identifier
1861028151
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- OTA-1732
- Practice address
- 3550 W Americana Ter
Boise, ID 83706-4728 - Phone
- (208) 615-4940
- NPI assigned
- Mar 18, 2020
- Sex
- Female
- Sole proprietor
- No
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 Therapy Assistant | 224Z00000X | OTA-1732 | ID | Primary |
Addresses
Primary practice location
3550 W Americana Ter
Boise, ID 83706-4728
Mailing address
3550 W Americana Ter
Boise, ID 83706-4728
Phone (208) 615-4940
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 |
|---|---|---|---|
| OTA-1732 | ID | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1584489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1584489600000",
"number": "1861028151",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3550 W AMERICANA TER",
"city": "BOISE",
"state": "ID",
"postal_code": "837064728",
"telephone_number": "208-615-4940"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3550 W AMERICANA TER",
"city": "BOISE",
"state": "ID",
"postal_code": "837064728",
"telephone_number": "208-615-4940"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MONTAMAT",
"first_name": "MARISSA",
"credential": "COTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-03-18",
"last_updated": "2020-03-18",
"certification_date": "2020-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "ID",
"license": "OTA-1732",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.