Individual provider Active NPI

Arielle Tenaya Marie Gout, OT

  • Occupational Therapist
  • Pasadena, CA
National Provider Identifier
1033517057
Registry record updated Dec 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT16754 Issued in CA
Practice address
2550 E Foothill Blvd
Pasadena, CA 91107-3406
Phone
(626) 463-1021
NPI assigned
Dec 8, 2014
Last updated
Dec 27, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 27, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Occupational Therapist 225X00000X OT16754 CA Primary

Addresses

Primary practice location

2550 E Foothill Blvd
Pasadena, CA 91107-3406

Mailing address

2550 E Foothill Blvd
Pasadena, CA 91107-3406
Phone (818) 901-6600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, VI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20221026001784 WI Practitioner - Occupational Therapist in Private Practice 6507147832 Reassigns benefits to 1 organization
I20241218003521 VI Practitioner - Occupational Therapist in Private Practice 6507147832 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cog Restore, LLCGroup PAC ID 1557665502, 10 clinicians

Practice addresses (Care Compare)

4006 Estate Diamond
Suite 103
St Croix, VI 00820-5352
Phone (340) 779-9355

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT16754CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Cog Restore, LLC CurrentSince Oct 15, 2024 Accepting new patients
Athletic & Therapeutic Institute of Milwaukee, LLC Occupational Therapist CurrentSince Sep 19, 2022 Accepting new patients
Athletic & Therapeutic Institute of Milwaukee, LLC CurrentSince Sep 19, 2022 Accepting new patients
Athletic & Therapeutic Institute of Milwaukee, LLC Occupational Therapist Current Accepting new patients
JS Therapies, LLC Occupational Therapist Past Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

2006 Eastern Suburb
Ste 9
Christiansted, VI 00820
Phone (340) 473-5924

4006 Estate Diamond
Ste 103
St Croix, VI 00820
Phone (340) 779-9355

9150 Estate Thomas
Ste 106108
St Thomas, VI 00802

S74W16867 Janesville Rd
Muskego, WI 53150
Phone (262) 971-4200

Organizations & group practices 5

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": "1417996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482796800000",
    "number": "1033517057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 E FOOTHILL BLVD",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911073406",
            "telephone_number": "818-901-6600",
            "fax_number": "818-901-6631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 E FOOTHILL BLVD",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911073406",
            "telephone_number": "626-463-1021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOUT",
        "first_name": "ARIELLE",
        "middle_name": "TENAYA MARIE",
        "credential": "OT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-08",
        "last_updated": "2016-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "OT16754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2016; 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.