Individual provider Active NPI

Amanda Jane Wetmore, OTR/L

  • Pediatric Occupational Therapist
  • Victor, NY
National Provider Identifier
1881346377
Registry record updated Aug 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
026537 Issued in NY
Practice address
590 Fishers Station Dr Ste 130
Victor, NY 14564-9744
Phone
(585) 924-7207
NPI assigned
Jan 25, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 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 026537 NY Primary

Addresses

Primary practice location

590 Fishers Station Dr Ste 130
Victor, NY 14564-9744

Mailing address

39 Calemad Dr
Auburn, NY 13021-9261
Phone (315) 604-0777

Other practice location 1

3767 Delaware Ave
Buffalo, NY 14217-1040
Phone (716) 874-6175

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
026537NYMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Physical & Occupational Therapists, PLLC PastSince Feb 1, 2022 Accepting new patients
Western New York Speech-Language Pathology, OT, and PT Consultants PastSince Aug 18, 2024 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1643068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723766400000",
    "number": "1881346377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 CALEMAD DR",
            "city": "AUBURN",
            "state": "NY",
            "postal_code": "130219261",
            "telephone_number": "315-604-0777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "590 FISHERS STATION DR STE 130",
            "city": "VICTOR",
            "state": "NY",
            "postal_code": "145649744",
            "telephone_number": "585-924-7207"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3767 Delaware Ave",
            "address_purpose": "LOCATION",
            "city": "Buffalo",
            "state": "NY",
            "postal_code": "142171040",
            "country_code": "US",
            "telephone_number": "716-874-6175",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WETMORE",
        "first_name": "AMANDA",
        "middle_name": "JANE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-25",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NY",
            "license": "026537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Victor, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 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.