Individual provider Active NPI

Tricia A Kiernan, OTR

  • Occupational Therapist
  • Gilbert, AZ
National Provider Identifier
1114126315
Registry record updated Feb 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5784 Issued in AZ
Practice address
3927 E Bautista Rd
Gilbert, AZ 85297-5202
Phone
(480) 322-8863
NPI assigned
Jul 17, 2007
Last updated
Feb 6, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 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 5784 AZ Primary

Addresses

Primary practice location

3927 E Bautista Rd
Gilbert, AZ 85297-5202

Mailing address

3927 E Bautista Rd
Gilbert, AZ 85297-5202
Phone (480) 322-8863

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180206000467 AZ Practitioner - Occupational Therapist in Private Practice 6800156183 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Amy Grulke PLLCGroup PAC ID 4284992538, 9 clinicians

Practice addresses (Care Compare)

2248 N Alma School Rd
Suite 102
Chandler, AZ 85224-2488
Phone (480) 935-0614

5750 W Thunderbird Rd
Suite E500
Glendale, AZ 85306-4669
Phone (480) 935-0614

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5784AZMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Amy Grulke, PLLC Occupational Therapist CurrentSince Jan 16, 2018 Accepting new patients

Locations

2248 N Alma School Rd
Ste 102
Chandler, AZ 85224
Phone (480) 899-9484

2950 N Dobson Rd
Ste 3
Chandler, AZ 85224
Phone 4809350614407

Organizations & group practices 1

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": "1184630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517875200000",
    "number": "1114126315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3927 E BAUTISTA RD",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852975202",
            "telephone_number": "480-322-8863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3927 E BAUTISTA RD",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852975202",
            "telephone_number": "480-322-8863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIERNAN",
        "first_name": "TRICIA",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-17",
        "last_updated": "2018-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AZ",
            "license": "5784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

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