Individual provider Active NPI

Ernest Regalado, COTA

  • Occupational Therapy Assistant
  • San Antonio, TX
National Provider Identifier
1154904845
Registry record updated Apr 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
216696 Issued in TX
Practice address
4207 Gardendale St Ste 104B
San Antonio, TX 78229-3142
Phone
(210) 582-5840
NPI assigned
Apr 30, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 216696 TX Primary

Addresses

Primary practice location

4207 Gardendale St Ste 104B
San Antonio, TX 78229-3142

Mailing address

3500 Goliad Rd Lot 152
San Antonio, TX 78223-4361

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
216696TXMDOccupational Therapy Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1619740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619740800000",
    "number": "1154904845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 GOLIAD RD LOT 152",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782234361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4207 GARDENDALE ST STE 104B",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293142",
            "telephone_number": "210-582-5840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REGALADO",
        "first_name": "ERNEST",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-30",
        "last_updated": "2021-04-30",
        "certification_date": "2021-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "TX",
            "license": "216696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2021; 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.