NPIMap

Individual provider Active NPI

John Mejasic

  • Occupational Therapist
  • Canby, OR
National Provider Identifier
1114308012
Registry record updated Oct 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
341015 Issued in OR
Practice address
113 N Elm St
Canby, OR 97013-3519
Phone
(503) 263-8903
Fax
(503) 266-8632
NPI assigned
Jun 16, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2019

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 341015 OR Primary

Addresses

Primary practice location

113 N Elm St
Canby, OR 97013-3519

Mailing address

113 N Elm St
Canby, OR 97013-3519
Phone (503) 263-8903

Other identifiers 1

IdentifierTypeStateIssuer
500768980MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
341015ORMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Theraplay, LLC Past Accepting new patients
Theraplay, LLC Occupational Therapist Past Accepting new patients

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": "1434412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570406400000",
    "number": "1114308012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 N ELM ST",
            "city": "CANBY",
            "state": "OR",
            "postal_code": "970133519",
            "telephone_number": "503-263-8903",
            "fax_number": "503-266-8632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 N ELM ST",
            "city": "CANBY",
            "state": "OR",
            "postal_code": "970133519",
            "telephone_number": "503-263-8903",
            "fax_number": "503-266-8632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEJASIC",
        "first_name": "JOHN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-16",
        "last_updated": "2019-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OR",
            "license": "341015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500768980",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canby, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.