Individual provider Active NPI

Susan E. Andre, O.T.R.

  • Occupational Therapist
  • Socorro, NM
National Provider Identifier
1013191428
Registry record updated Jan 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT-2026-0017 Issued in NM
Practice address
1202 Highway 60
Socorro, NM 87801-3914
Phone
(575) 835-1140
NPI assigned
Dec 20, 2007
Last updated
Jan 28, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT-2026-0017 NM Primary
Occupational Therapist 225X00000X 105821 TX
Hand Occupational Therapist 225XH1200X NU
Physical Rehabilitation Occupational Therapist 225XP0019X NU

Addresses

Primary practice location

1202 Highway 60
Socorro, NM 87801-3914

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (866) 370-8206

Other practice location 1

4843 Colleyville Blvd Ste 221
Colleyville, TX 76034-3986
Phone (972) 979-6577

Other practice location 2

12345 Alta Vista Rd Ste 113
Fort Worth, TX 76244-6436
Phone (682) 593-2550

Other practice location 3

4843 Colleyville Blvd Ste 221
Colleyville, TX 76034-3986
Phone (972) 979-6577

Other identifiers 1

IdentifierTypeStateIssuer
TXB115376OtherTXMEDICARE PTAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110111000571 TX Practitioner - Occupational Therapist in Private Practice 6608065362 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4843 Colleyville Blvd
Suite 221
Colleyville, TX 76034-3986
Phone (817) 576-7520

Merit-based Incentive Payment System (MIPS)

Final score
85.56 of 100Reported as group
Quality
89.48
Improvement activities
40
Cost
71.16

Merit-based Incentive Payment System (MIPS)

Final score
86.32 of 100Reported as group
Quality
84.44
Promoting interoperability
99
Improvement activities
40
Cost
70.78

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT-2026-0017NMMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ideal Physical Therapy of Texas LLC Occupational Therapist CurrentSince Aug 22, 2024 Accepting new patients
Ideal Physical Therapy of Texas LLC CurrentSince Aug 22, 2024 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

17051 Dallas Pkwy
Ste 450
Addison, TX 75001
Phone (214) 272-8561

1827 SW Green Oaks Blvd
Ste 143
Arlington, TX 76017
Phone (512) 501-4783

4100 Fairway Dr
Ste 400
Carrollton, TX 75010
Phone (972) 394-3325

4843 Colleyville Blvd
Ste 221
Colleyville, TX 76034
Phone (817) 576-7520

2600 W 7th St
Ste 137
Fort Worth, TX 76107
Phone (682) 233-6462

6420 N MacArthur Blvd
Ste 130
Irving, TX 75039
Phone (972) 402-8300

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1198108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769558400000",
    "number": "1013191428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "866-370-8206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 HIGHWAY 60",
            "city": "SOCORRO",
            "state": "NM",
            "postal_code": "878013914",
            "telephone_number": "575-835-1140"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4843 Colleyville Blvd Ste 221",
            "address_purpose": "LOCATION",
            "city": "Colleyville",
            "state": "TX",
            "postal_code": "760343986",
            "country_code": "US",
            "telephone_number": "972-979-6577",
            "fax_number": "972-979-6951",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12345 Alta Vista Rd Ste 113",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "762446436",
            "country_code": "US",
            "telephone_number": "682-593-2550",
            "fax_number": "817-540-5633",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4843 Colleyville Blvd Ste 221",
            "address_purpose": "LOCATION",
            "city": "Colleyville",
            "state": "TX",
            "postal_code": "760343986",
            "country_code": "US",
            "telephone_number": "972-979-6577",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDRE",
        "first_name": "SUSAN",
        "middle_name": "E.",
        "name_prefix": "Mrs.",
        "credential": "O.T.R.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-20",
        "last_updated": "2026-01-28",
        "certification_date": "2026-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NM",
            "license": "OT-2026-0017",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "105821",
            "primary": false
        },
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "TXB115376",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Socorro, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.