Individual provider Active NPI

Samantha Demattie, OTD, OTR/L

  • Occupational Therapist
  • Cleveland, OH
National Provider Identifier
1942740725
Registry record updated Dec 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT011606 Issued in OH
Practice address
1111 Superior Ave E Ste 1800
Cleveland, OH 44114-2500
Phone
(216) 838-0000
NPI assigned
Feb 28, 2017
Reactivated
Aug 25, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2024

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 OT011606 OH Primary

Addresses

Primary practice location

1111 Superior Ave E Ste 1800
Cleveland, OH 44114-2500

Mailing address

771 E Pleasant Valley Rd
Seven Hills, OH 44131-5609
Phone (314) 610-8158

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
OT011606OHMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Cleveland Metropolitan School District CurrentSince May 4, 2025 Accepting new patients

Locations

1111 Superior Ave
Ste 1800
Cleveland, OH 44114
Phone (216) 592-7237

Organizations & group practices 1

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": "1488240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733270400000",
    "number": "1942740725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "771 E PLEASANT VALLEY RD",
            "city": "SEVEN HILLS",
            "state": "OH",
            "postal_code": "441315609",
            "telephone_number": "314-610-8158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 SUPERIOR AVE E STE 1800",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441142500",
            "telephone_number": "216-838-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMATTIE",
        "first_name": "SAMANTHA",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-28",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-03",
        "deactivation_date": "2021-08-16",
        "reactivation_date": "2021-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OH",
            "license": "OT011606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 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.