Active NPI
Mia Theado, OTR/L
- Occupational Therapist
- Columbus, OH
National Provider Identifier
1043840440
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT-5405
- Practice address
- 53 Westwood Rd
Columbus, OH 43214-3015 - Phone
- (614) 937-3365
- NPI assigned
- Jan 24, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT-5405 | OH | Primary |
Addresses
Primary practice location
53 Westwood Rd
Columbus, OH 43214-3015
Mailing address
53 Westwood Rd
Columbus, OH 43214-3015
Phone (614) 937-3365
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200316001512 | OH | Practitioner - Occupational Therapist in Private Practice | 8123456696 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Occupational Therapist in Private Practice
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Affordable Home Health Care LLC
Practice addresses (Care Compare)
800 Yard St
Suite 300
Grandview Heights, OH 43212-3882
Phone (614) 866-8158
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT-5405 | OH | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Affordable Home Health Care, LLC | Current | Accepting new patients | |
| Affordable Home Health Care, LLC | Occupational Therapist | Current | Accepting new patients |
Locations
800 Yard St
Ste 300
Grandview Heights, OH 43212
Phone (614) 866-8158
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 and National Provider Directory roles.
-
- Physical Therapist
- Columbus, OH
- NPI 1457216277
Occupational Therapist, OH
-
- Home Health Agency
- Grandview Heights, OH
- NPI 1861413999
-
- Home Health Agency
- Blue Ash, OH
- NPI 1588029284
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1579824000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1579824000000",
"number": "1043840440",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "53 WESTWOOD RD",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432143015",
"telephone_number": "614-937-3365"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "53 WESTWOOD RD",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432143015",
"telephone_number": "614-937-3365"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THEADO",
"first_name": "MIA",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-01-24",
"last_updated": "2020-01-24",
"certification_date": "2020-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "OH",
"license": "OT-5405",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Columbus, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 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.