Individual provider Active NPI

Greg Tracy Goertzen, OTR

  • Occupational Therapist
  • Kansas City, MO
National Provider Identifier
1063481901
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
001136 Issued in MO
Practice address
8880 NE 82ND Ter
Kansas City, MO 64158-1313
Phone
(816) 437-8262
NPI assigned
Mar 14, 2006
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 001136 MO Primary

Addresses

Primary practice location

8880 NE 82ND Ter
Kansas City, MO 64158-1313

Mailing address

8880 NE 82ND Ter
Kansas City, MO 64158-1313
Phone (816) 437-8262

Other practice location 1

3107 Frederick Ave
Saint Joseph, MO 64506-2911
Phone (816) 233-9555

Other practice location 2

3107 Frederick Ave
Saint Joseph, MO 64506-2911
Phone (816) 233-9555

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060810000458 MO Practitioner - Occupational Therapist in Private Practice 9830192988 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Athletico LTDGroup PAC ID 4789602681, 2,187 clinicians

Practice addresses (Care Compare)

4029 Mill St
Kansas City, MO 64111-3008
Phone (816) 285-0022

Merit-based Incentive Payment System (MIPS)

Final score
86.32 of 100Reported as group
Quality
84.44
Promoting interoperability
99
Improvement activities
40
Cost
70.78

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
001136MOMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Athletico LTD Occupational Therapist CurrentSince Aug 20, 2021 Accepting new patients
Athletico LTD Occupational Therapist Current Accepting new patients
Athletico LTD Occupational Therapist CurrentSince Aug 20, 2021 Accepting new patients
Saint Luke's Neighborhood Clinics, LLC Past Accepting new patients
Midwest Rehabilitation Inc Past Accepting new patients

Locations

2122 York Rd
Ste 300
Oak Brook, IL 60523
Phone (630) 575-6250

4029 Mill St
Kansas City, MO 64111
Phone (816) 285-0022

229 S Stewart Rd
Ste E3
Liberty, MO 64068
Phone (816) 656-3695

2007 W Foxwood Dr
Ste D
Raymore, MO 64083
Phone (816) 265-8116

1832 Wentzville Pkwy
Wentzville, MO 63385
Phone (636) 327-7110

Interoperability endpoints

  • Direct secure messaging: greg.goertzen.p9@direct.athleticoltd.nextgenshare.com

Organizations & group practices 5

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": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1063481901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8880 NE 82ND TER",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641581313",
            "telephone_number": "816-437-8262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8880 NE 82ND TER",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641581313",
            "telephone_number": "816-437-8262"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3107 Frederick Ave",
            "address_purpose": "LOCATION",
            "city": "Saint Joseph",
            "state": "MO",
            "postal_code": "645062911",
            "country_code": "US",
            "telephone_number": "816-233-9555",
            "fax_number": "816-279-1423",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3107 Frederick Ave",
            "address_purpose": "LOCATION",
            "city": "Saint Joseph",
            "state": "MO",
            "postal_code": "645062911",
            "country_code": "US",
            "telephone_number": "816-233-9555",
            "fax_number": "816-279-1423",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOERTZEN",
        "first_name": "GREG",
        "middle_name": "TRACY",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MO",
            "license": "001136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.