Individual provider Active NPI

Ivettedari Miranda-Capella, OTR/L

  • Occupational Therapist
  • New York, NY
National Provider Identifier
1932619277
Registry record updated Sep 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
020358-1 Issued in NY
Practice address
549 Audubon Ave
New York, NY 10040-3401
Phone
(646) 254-6451
NPI assigned
Sep 30, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2017

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 020358-1 NY Primary

Addresses

Primary practice location

549 Audubon Ave
New York, NY 10040-3401

Mailing address

461 Pavonia Ave FL 2
Jersey City, NJ 07306-1309
Phone (787) 235-9592

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
020358-1NYMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1506729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506729600000",
    "number": "1932619277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "461 PAVONIA AVE FL 2",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073061309",
            "telephone_number": "787-235-9592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "549 AUDUBON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100403401",
            "telephone_number": "646-254-6451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRANDA-CAPELLA",
        "first_name": "IVETTEDARI",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-30",
        "last_updated": "2017-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "020358-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2017; 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.