Individual provider Active NPI

Russell Nakajima, OTR/L

  • Hand Occupational Therapist
  • Thousand Oaks, CA
National Provider Identifier
1063298164
Registry record updated Apr 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hand Occupational TherapistTaxonomy code 225XH1200X
License
26282 Issued in CA
Practice address
550 Saint Charles Dr Ste 100
Thousand Oaks, CA 91360-3969
Phone
(805) 449-1125
Fax
(805) 449-4113
NPI assigned
Sep 5, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hand Occupational Therapist 225XH1200X 26282 CA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

550 Saint Charles Dr Ste 100
Thousand Oaks, CA 91360-3969

Mailing address

550 Saint Charles Dr Ste 100
Thousand Oaks, CA 91360-3969
Phone (805) 449-1125

Other practice location 1

696 Hampshire Rd # 180A
Westlake Village, CA 91361-2699
Phone (805) 497-1700

Other practice location 2

18911 Nordhoff St Ste 37
Northridge, CA 91324-3774
Phone (805) 497-1700

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240521003907 CA Practitioner - Occupational Therapist in Private Practice 6507208659 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bay Rehabilitation IncGroup PAC ID 4082790506, 11 clinicians

Practice addresses (Care Compare)

3413 W Pacific Ave
Suite 200
Burbank, CA 91505-1598
Phone (818) 593-4270

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26282CAMDHand Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bay Rehabilitation Inc CurrentSince Jun 1, 2025 Accepting new patients
Meridian Hand Therapy Inc Hand CurrentSince May 9, 2024 Accepting new patients
Meridian Hand Therapy Inc Hand CurrentSince May 9, 2024 Accepting new patients
Special Service for Groups, Inc. PastSince Sep 1, 2023 Accepting new patients

Locations

3413 W Pacific Ave
Ste 200
Burbank, CA 91505
Phone (818) 841-3936

1520 W Beverly Blvd
Montebello, CA 90640
Phone (323) 725-0711

18911 Nordhoff St
Ste 37
Northridge, CA 91324
Phone (818) 435-2800

550 Saint Charles Dr
Ste 100
Thousand Oaks, CA 91360
Phone (805) 449-1125

Organizations & group practices 4

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1693872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713398400000",
    "number": "1063298164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 SAINT CHARLES DR STE 100",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913603969",
            "telephone_number": "805-449-1125",
            "fax_number": "805-449-4113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 SAINT CHARLES DR STE 100",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913603969",
            "telephone_number": "805-449-1125",
            "fax_number": "805-449-4113"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "696 Hampshire Rd # 180A",
            "address_purpose": "LOCATION",
            "city": "Westlake Village",
            "state": "CA",
            "postal_code": "913612699",
            "country_code": "US",
            "telephone_number": "805-497-1700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18911 Nordhoff St Ste 37",
            "address_purpose": "LOCATION",
            "city": "Northridge",
            "state": "CA",
            "postal_code": "913243774",
            "country_code": "US",
            "telephone_number": "805-497-1700",
            "fax_number": "818-435-2810",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NAKAJIMA",
        "first_name": "RUSSELL",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-05",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "CA",
            "license": "26282",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thousand Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2024; 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.