Individual provider Active NPI

Emily Lauren Pavelsek, OTR

  • Occupational Therapist
  • Glendale, WI
National Provider Identifier
1013681501
Registry record updated Jan 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
7079-26 Issued in WI
Practice address
1700 W Bender Rd
Glendale, WI 53209-3852
Phone
(414) 351-0505
NPI assigned
Aug 6, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2023

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 7079-26 WI Primary

Addresses

Primary practice location

1700 W Bender Rd
Glendale, WI 53209-3852

Mailing address

2655 S 64TH St
West Allis, WI 53219-2644
Phone (813) 751-5249

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address WI02@westongroupinc.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211101001071 WI Practitioner - Occupational Therapist in Private Practice 6901294552 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Paxxon Healthcare Services LLCGroup PAC ID 8325959554, 153 clinicians

Practice addresses (Care Compare)

6600 River Pkwy
Wauwatosa, WI 53213-3292
Phone (414) 476-8787

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7079-26WIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Paxxon Healthcare Services LLC Occupational Therapist CurrentSince Aug 6, 2021 Accepting new patients
Paxxon Healthcare Services LLC Occupational Therapist CurrentSince Aug 6, 2021 Accepting new patients

Locations

1111 E Capitol Dr
Shorewood, WI 53211
Phone (262) 293-3207

Interoperability endpoints

  • Direct secure messaging: wi02@westongroupinc.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1628208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673913600000",
    "number": "1013681501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2655 S 64TH ST",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532192644",
            "telephone_number": "813-751-5249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 W BENDER RD",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532093852",
            "telephone_number": "414-351-0505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAVELSEK",
        "first_name": "EMILY",
        "middle_name": "LAUREN",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-06",
        "last_updated": "2023-01-17",
        "certification_date": "2023-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "7079-26",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "WI02@westongroupinc.com",
            "affiliation": "N",
            "endpointDescription": "Therapy services email",
            "address_1": "1700 W Bender Rd",
            "city": "Glendale",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532093852",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Glendale, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2023; 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.