Individual provider Active NPI

Megan Fitch, OTR/L

  • Occupational Therapist
  • Elm Grove, WI
National Provider Identifier
1043748890
Registry record updated Oct 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
6092-26 Issued in WI
Practice address
800 Wall St
Elm Grove, WI 53122-2631
Phone
(262) 282-8459
NPI assigned
May 24, 2017
Last updated
Oct 21, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2021

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 6092-26 WI Primary

Addresses

Primary practice location

800 Wall St
Elm Grove, WI 53122-2631

Mailing address

6165 Walnut LN Unit 92
Cudahy, WI 53110-3467
Phone (224) 399-5463

Other names 1

  • Megan Cassidy Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170623001162 WI Practitioner - Occupational Therapist in Private Practice 8426326927 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
Aegis Group Practice LLCGroup PAC ID 5193036432, 399 clinicians

Practice addresses (Care Compare)

S64W13780 Janesville Rd
Muskego, WI 53150-2743
Phone (414) 217-7925

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6092-26WIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Aegis Group Practice LLC Occupational Therapist Current Accepting new patients
Aegis Group Practice LLC Occupational Therapist CurrentSince Jul 30, 2021 Accepting new patients
Aegis Group Practice LLC Occupational Therapist CurrentSince Jul 30, 2021 Accepting new patients

Locations

4933 Old Greenwood Rd
Fort Smith, AR 72903

2586 Valley Rd
Plymouth, WI 53073
Phone (920) 892-4635

831 E Washington St
West Bend, WI 53095
Phone (262) 335-1992

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": "1495584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634774400000",
    "number": "1043748890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6165 WALNUT LN UNIT 92",
            "city": "CUDAHY",
            "state": "WI",
            "postal_code": "531103467",
            "telephone_number": "224-399-5463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 WALL ST",
            "city": "ELM GROVE",
            "state": "WI",
            "postal_code": "531222631",
            "telephone_number": "262-282-8459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITCH",
        "first_name": "MEGAN",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-24",
        "last_updated": "2021-10-21",
        "certification_date": "2021-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "6092-26",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEGAN",
            "last_name": "CASSIDY",
            "credential": "OTR/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Elm Grove, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2021; 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.