Individual provider Active NPI

Harold Neuendorff, OTRL, CHT

  • Occupational Therapist
  • Redlands, CA
National Provider Identifier
1053452680
Registry record updated Feb 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT3990 Issued in CA
Practice address
1901 W Lugonia Ave
Suite 240
Redlands, CA 92374-9703
Phone
(909) 557-1600
Fax
(909) 557-1740
NPI assigned
Feb 8, 2007
Last updated
Feb 3, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2010

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 OT3990 CA Primary

Addresses

Primary practice location

1901 W Lugonia Ave
Suite 240
Redlands, CA 92374-9703

Mailing address

PO Box 8520
Redlands, CA 92375-1720
Phone (909) 557-1600

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050718000649 CA Practitioner - Occupational Therapist in Private Practice 6305872730 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1901 W Lugonia Ave
Redlands, CA 92374-9703
Phone (909) 557-1600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
San Bernardino Medical Orthopaedic Group, Inc. CurrentSince May 1, 2005 Accepting new patients
San Bernardino Medical Orthopaedic Group, Inc. CurrentSince May 1, 2005 Accepting new patients
San Bernardino Medical Group Inc Past Accepting new patients

Locations

1798 N Garey Ave
Pomona, CA 91767
Phone (909) 865-9810

1801 Orange Tree Ln
Ste 200
Redlands, CA 92374
Phone (909) 557-1607

1901 W Lugonia Ave
Ste 120
Redlands, CA 92374
Phone (909) 557-1626

1901 W Lugonia Ave
Ste 210
Redlands, CA 92374
Phone (909) 557-1653

1901 W Lugonia Ave
Ste 240
Redlands, CA 92374
Phone (909) 557-1630

1901 W Lugonia Ave
Ste 310
Redlands, CA 92374
Phone (909) 793-2964

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265155200000",
    "number": "1053452680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8520",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923751720",
            "telephone_number": "909-557-1600",
            "fax_number": "909-557-1740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 W LUGONIA AVE",
            "address_2": "SUITE 240",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923749703",
            "telephone_number": "909-557-1600",
            "fax_number": "909-557-1740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEUENDORFF",
        "first_name": "HAROLD",
        "credential": "OTRL, CHT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-08",
        "last_updated": "2010-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "OT3990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redlands, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2010; 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.