Individual provider Active NPI

Jamie Luong, OTD, OTR/L

  • Occupational Therapist
  • Garden Grove, CA
National Provider Identifier
1154841864
Registry record updated Oct 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Practice address
12131 Brookhurst St
Garden Grove, CA 92840-2863
Phone
(714) 360-8828
NPI assigned
Jun 23, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 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 Primary

Addresses

Primary practice location

12131 Brookhurst St
Garden Grove, CA 92840-2863

Mailing address

1079 Tulare Dr
Costa Mesa, CA 92626-2112
Phone (714) 657-4732

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241120004686 CA Practitioner - Occupational Therapist in Private Practice 2365977881 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Global Physical Therapy and WellnessGroup PAC ID 5890103162, 14 clinicians

Practice addresses (Care Compare)

12131 Brookhurst St
Suite B
Garden Grove, CA 92840-2863
Phone (714) 360-8828

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
23662CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Global Physical Therapy and Wellness Occupational Therapist CurrentSince Oct 21, 2024 Accepting new patients
Global Physical Therapy and Wellness CurrentSince Oct 21, 2024 Accepting new patients
Footprints Behavior Interventions PastSince Jul 24, 2022 Accepting new patients
Footprints Behavioral Interventions, Inc. Occupational Therapist PastSince Jul 1, 2022 Accepting new patients

Locations

12131 Brookhurst St
Ste B
Garden Grove, CA 92840
Phone (714) 360-8828

Organizations & group practices 4

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": "1498176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728864000000",
    "number": "1154841864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1079 TULARE DR",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926262112",
            "telephone_number": "714-657-4732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12131 BROOKHURST ST",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928402863",
            "telephone_number": "714-360-8828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUONG",
        "first_name": "JAMIE",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-23",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 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.