Individual provider Active NPI

Alycia Marie Dezell, OTR/L

  • Occupational Therapist
  • Ogdensburg, NY
National Provider Identifier
1982913166
Registry record updated Jan 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
015947-1 Issued in NY
Practice address
8101 State Highway 68
Ogdensburg, NY 13669-4403
Phone
(315) 393-3070
Fax
(315) 393-3014
NPI assigned
Oct 5, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 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 015947-1 NY Primary

Addresses

Primary practice location

8101 State Highway 68
Ogdensburg, NY 13669-4403

Mailing address

8101 State Highway 68
Ogdensburg, NY 13669-4403
Phone (315) 393-3070

Other identifiers 1

IdentifierTypeStateIssuer
015947-1OtherNYOCCUPATIONAL THERAPIST

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
015947-1NYMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1286236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485388800000",
    "number": "1982913166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8101 STATE HIGHWAY 68",
            "city": "OGDENSBURG",
            "state": "NY",
            "postal_code": "136694403",
            "telephone_number": "315-393-3070",
            "fax_number": "315-393-3014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8101 STATE HIGHWAY 68",
            "city": "OGDENSBURG",
            "state": "NY",
            "postal_code": "136694403",
            "telephone_number": "315-393-3070",
            "fax_number": "315-393-3014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEZELL",
        "first_name": "ALYCIA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-05",
        "last_updated": "2017-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "015947-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OCCUPATIONAL THERAPIST",
            "identifier": "015947-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ogdensburg, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 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.