Individual provider Active NPI

Sharon Lynn Kuznetsov, OTR/L, CHT

  • Occupational Therapist
  • Bainbridge Island, WA
National Provider Identifier
1043264518
Registry record updated Jan 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT00003756 Issued in WA
Practice address
563 Madison Ave N
Bainbridge Island, WA 98110-1768
Phone
(206) 855-8455
Fax
(206) 855-8465
NPI assigned
May 20, 2006
Last updated
Jan 8, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT00003756 WA Primary
Hand Occupational Therapist 225XH1200X OT00003759 WA

Addresses

Primary practice location

563 Madison Ave N
Bainbridge Island, WA 98110-1768

Mailing address

563 Madison Ave N
Bainbridge Island, WA 98110-1768
Phone (206) 855-8455

Other identifiers 3

IdentifierTypeStateIssuer
G8948780OtherWAMEDICARE
P00264836OtherRAILROAD MEDICARE
8379364MedicaidWA

Other names 1

  • Sharon Hoesel Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040402001494 WA Practitioner - Occupational Therapist in Private Practice 4284627696 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bainbridge Island Physical Therapy, LLCGroup PAC ID 9537051073, 9 clinicians

Practice addresses (Care Compare)

563 Madison Ave N
Bainbridge Island, WA 98110-1768
Phone (206) 855-8455

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT00003756WAMDOccupational Therapist
OT00003759WAMDHand Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bainbridge Island Physical Therapy, LLC CurrentSince Jan 18, 2016 Accepting new patients
Strait Orthopedic Specialists. PS PastSince Apr 1, 2001 Accepting new patients
Center for Bone & Joint Surgery LTD PastSince Aug 4, 1999 Accepting new patients

Locations

563 Madison Ave N
Bainbridge Island, WA 98110
Phone (206) 855-8455

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/22724/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578441600000",
    "number": "1043264518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "563 MADISON AVE N",
            "city": "BAINBRIDGE ISLAND",
            "state": "WA",
            "postal_code": "981101768",
            "telephone_number": "206-855-8455",
            "fax_number": "206-855-8465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "563 MADISON AVE N",
            "city": "BAINBRIDGE ISLAND",
            "state": "WA",
            "postal_code": "981101768",
            "telephone_number": "206-855-8455",
            "fax_number": "206-855-8465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUZNETSOV",
        "first_name": "SHARON",
        "middle_name": "LYNN",
        "credential": "OTR/L, CHT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-20",
        "last_updated": "2020-01-08",
        "certification_date": "2020-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WA",
            "license": "OT00003756",
            "primary": true
        },
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "WA",
            "license": "OT00003759",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "G8948780",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00264836",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8379364",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHARON",
            "last_name": "HOESEL",
            "credential": "OTR/L, CHT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bainbridge Island, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2020; 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.