Individual provider Active NPI

Mary Grace Lagasca

  • Occupational Therapist
  • Rockwall, TX
National Provider Identifier
1083477541
Registry record updated Feb 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
124263 Issued in TX
Practice address
225 E Ralph Hall Pkwy
Rockwall, TX 75032-6815
Phone
(877) 407-3422
Fax
(877) 407-4329
NPI assigned
Feb 6, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2024

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 124263 TX Primary

Addresses

Primary practice location

225 E Ralph Hall Pkwy
Rockwall, TX 75032-6815

Mailing address

7 Carnegie PLZ
Cherry Hill, NJ 08003-1000
Phone (877) 407-3422

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, AK2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240219000436 TX Practitioner - Occupational Therapist in Private Practice 7810331824 Reassigns benefits to 1 organization
I20250206000223 AK Practitioner - Occupational Therapist in Private Practice 7810331824 Reassigns benefits to 1 organization

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
Authentic Living LLCGroup PAC ID 1658764741, 3 clinicians

Practice addresses (Care Compare)

4440 Woronzof Dr
Anchorage, AK 99517-1497
Phone (907) 531-9443

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
124263TXMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Rehabilitation Services TX LLC Occupational Therapist CurrentSince Feb 1, 2024 Accepting new patients
Authentic Living, LLC Occupational Therapist CurrentSince Jan 1, 2025 Accepting new patients

Locations

7 Carnegie Plz
Cherry Hill, NJ 08003

4101 W Arkansas Ln
Arlington, TX 76016
Phone (817) 469-7671

13001 Hillcrest Rd
Dallas, TX 75240
Phone (972) 385-5267

225 E Ralph Hall Pkwy
Rockwall, TX 75032
Phone (469) 402-1883

6327 Cypresswood Dr
Spring, TX 77379
Phone (281) 374-1750

Organizations & group practices 2

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": "1707177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707177600000",
    "number": "1083477541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 CARNEGIE PLZ",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080031000",
            "telephone_number": "877-407-3422",
            "fax_number": "877-407-4329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 E RALPH HALL PKWY",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750326815",
            "telephone_number": "877-407-3422",
            "fax_number": "877-407-4329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAGASCA",
        "first_name": "MARY GRACE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-06",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "124263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockwall, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 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.