Individual provider Active NPI

Kaitlin Hellenbrand, M.S. OTR/L

  • Occupational Therapist
  • Madison, WI
National Provider Identifier
1104187079
Registry record updated Mar 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
4991-026 Issued in WI
Practice address
5249 East Terrace Drive
Madison, WI 53718
Phone
(608) 662-5060
NPI assigned
Jun 6, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2017

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 4991-026 WI Primary

Addresses

Primary practice location

5249 East Terrace Drive
Madison, WI 53718

Mailing address

5249 East Terrace Drive
Madison, WI 53718

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120905000579 WI Practitioner - Occupational Therapist in Private Practice 8325295843 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Group Health Cooperative of South Central WisconsinGroup PAC ID 3870489586, 233 clinicians

Practice addresses (Care Compare)

5249 E Terrace Dr
Madison, WI 53718-8339
Phone (608) 222-9777

675 W Washington Ave
Madison, WI 53703-2637
Phone (608) 257-9700

8202 Excelsior Dr
Madison, WI 53717-1906
Phone (608) 831-1766

Merit-based Incentive Payment System (MIPS)

Final score
82.21 of 100Reported as group
Quality
71.09
Promoting interoperability
99
Improvement activities
40
Cost
70.44

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
4991WIMDAnesthesiology Physician
4991-026WIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Group Health Cooperative of South Central Wisconsin CurrentSince Jun 18, 2012 Accepting new patients
Group Health Cooperative of South Central Wi - Princeton Club Past Accepting new patients

Locations

5249 E Terrace Dr
Madison, WI 53718
Phone (608) 222-9777

675 W Washington Ave
Madison, WI 53703
Phone (608) 257-5178

8202 Excelsior Dr
Madison, WI 53717
Phone (608) 831-1766

8054 Watts Rd
Madison, WI 53719
Phone (608) 662-5060

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": "1338940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488758400000",
    "number": "1104187079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5249 EAST TERRACE DRIVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "53718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5249 EAST TERRACE DRIVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "53718",
            "telephone_number": "608-662-5060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HELLENBRAND",
        "first_name": "KAITLIN",
        "credential": "M.S. OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-06",
        "last_updated": "2017-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "4991-026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2017; 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.