Individual provider Active NPI

Mary L McClusky, O.T.

  • Specialist
  • Watertown, NY
National Provider Identifier
1962470518
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
0060281 Issued in NY
Practice address
19472 US Route 11
Watertown, NY 13601-5387
Phone
(315) 782-6126
Fax
(315) 782-3816
NPI assigned
Mar 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 0060281 NY Primary

Addresses

Primary practice location

19472 US Route 11
Watertown, NY 13601-5387

Mailing address

216 County Route 64
Mexico, NY 13114-3229
Phone (315) 963-5421

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050228000512 NY Practitioner - Occupational Therapist in Private Practice 3779536917 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0060281NYMDSpecialist
006028NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Cani PT OT SLP & Psychology PLLC Specialist CurrentSince Jan 1, 1999 Accepting new patients

Locations

216 County Route 64
Mexico, NY 13114
Phone (315) 963-0864

19472 US Route 11
Watertown, NY 13601
Phone (315) 782-6126

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": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1962470518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 COUNTY ROUTE 64",
            "city": "MEXICO",
            "state": "NY",
            "postal_code": "131143229",
            "telephone_number": "315-963-5421",
            "fax_number": "315-963-7693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19472 US ROUTE 11",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136015387",
            "telephone_number": "315-782-6126",
            "fax_number": "315-782-3816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLUSKY",
        "first_name": "MARY",
        "middle_name": "L",
        "credential": "O.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-09",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "0060281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.

Verify at the official NPI Registry.