Active NPI
Kathryn Matala Matsubuchi, OT
- Occupational Therapist
- Spokane, WA
National Provider Identifier
1093925943
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT00002727
- Practice address
- 3010 S Southeast Blvd Ste G
Spokane, WA 99223-3542 - Phone
- (509) 532-0500
- Fax
- (509) 532-8810
- NPI assigned
- May 22, 2007
- 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 | OT00002727 | WA | Primary |
Addresses
Primary practice location
3010 S Southeast Blvd Ste G
Spokane, WA 99223-3542
Mailing address
3010 S Southeast Blvd Ste G
Spokane, WA 99223-3542
Phone (509) 532-0500
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0351054 | Other | WA | DEPT OF L&I |
| 1056882 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Occupational Therapist in Private Practice
- Education
- Other, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
12012 E Mission Ave
Spokane Valley, WA 99206-4887
Phone (509) 413-1630
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT00002727 | WA | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Larry Ham and Associates Physical Therapy PS | Occupational Therapist | Current | Accepting new patients |
| Synergy Healthcare Inc. | Current | Accepting new patients | |
| Spokane Foot Clinic, P S | Past | Accepting new patients |
Locations
3151 E 29th Ave
Spokane, WA 99223
Phone (509) 532-0500
3010 S Southeast Blvd
Ste G
Spokane, WA 99223
Phone (509) 532-0500
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
- Spokane Valley, WA
- NPI 1780741439
-
- Physical Therapist
- Spokane, WA
- NPI 1811098239
Occupational Therapist
-
- Podiatric Clinic/Center
- Spokane, WA
- NPI 1215012331
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1619049600000",
"number": "1093925943",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3010 S SOUTHEAST BLVD STE G",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992233542",
"telephone_number": "509-532-0500",
"fax_number": "509-532-8810"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3010 S SOUTHEAST BLVD STE G",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992233542",
"telephone_number": "509-532-0500",
"fax_number": "509-532-8810"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATSUBUCHI",
"first_name": "KATHRYN",
"middle_name": "MATALA",
"name_prefix": "Mrs.",
"credential": "OT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-22",
"last_updated": "2021-04-22",
"certification_date": "2021-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WA",
"license": "OT00002727",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPT OF L&I",
"identifier": "0351054",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1056882",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Spokane, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2021; 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.