Active NPI
Mia Lopez
- Occupational Therapist
- New Haven, CT
National Provider Identifier
1932920584
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 6278
- Practice address
- 118 Clinton Ave
New Haven, CT 06513-3199 - Phone
- (203) 562-7222
- NPI assigned
- Oct 17, 2024
- 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 Therapist | 225X00000X | 6278 | CT | Primary |
Addresses
Primary practice location
118 Clinton Ave
New Haven, CT 06513-3199
Mailing address
520 Washington Ave Apt 2201
North Haven, CT 06473-1398
Phone (916) 849-8833
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241105000582 | CT | Practitioner - Occupational Therapist in Private Practice | 0840723433 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1729123200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729123200000",
"number": "1932920584",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "520 WASHINGTON AVE APT 2201",
"city": "NORTH HAVEN",
"state": "CT",
"postal_code": "064731398",
"telephone_number": "916-849-8833"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "118 CLINTON AVE",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "065133199",
"telephone_number": "203-562-7222"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOPEZ",
"first_name": "MIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-10-17",
"last_updated": "2024-10-17",
"certification_date": "2024-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CT",
"license": "6278",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Haven, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.