Individual provider Active NPI

Jared Stuck, OT

  • Occupational Therapist
  • Scottsdale, AZ
National Provider Identifier
1023665387
Registry record updated Aug 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OTH-007918 Issued in AZ
Practice address
16413 N 91St St BLDG C145
Scottsdale, AZ 85260-3056
Phone
(480) 447-3262
Fax
(480) 630-2066
NPI assigned
Aug 21, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2019

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 OTH-007918 AZ Primary

Addresses

Primary practice location

16413 N 91St St BLDG C145
Scottsdale, AZ 85260-3056

Mailing address

7349 N Via Paseo del Sur # 442
Scottsdale, AZ 85258-3765
Phone (480) 447-3262

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191212000623 AZ Practitioner - Occupational Therapist in Private Practice 0446683098 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Theraplay4Kidz, LLC Occupational Therapist CurrentSince Nov 1, 2019 Accepting new patients
Achievement Therapy Services Past Accepting new patients

Locations

21630 N 19th Ave
Ste B3
Phoenix, AZ 85027
Phone (480) 235-7588

530 E McDowell Rd
Ste 107495
Phoenix, AZ 85004

9525 E Doubletree Ranch Rd
Ste 101
Scottsdale, AZ 85258
Phone (480) 488-3946

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": "1566345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566345600000",
    "number": "1023665387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7349 N VIA PASEO DEL SUR # 442",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852583765",
            "telephone_number": "480-447-3262",
            "fax_number": "480-630-2066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16413 N 91ST ST BLDG C145",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852603056",
            "telephone_number": "480-447-3262",
            "fax_number": "480-630-2066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUCK",
        "first_name": "JARED",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-21",
        "last_updated": "2019-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AZ",
            "license": "OTH-007918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2019; 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.