Individual provider Active NPI

Madeline Grace Thueson, OTR/L

  • Occupational Therapist
  • Surprise, AZ
National Provider Identifier
1164093266
Registry record updated Jul 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OTH-007437 Issued in AZ
Practice address
18510 N Parkview PL
Surprise, AZ 85374-4294
Phone
(623) 244-4482
NPI assigned
Jul 8, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2021

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 OTH-007437 AZ Primary

Addresses

Primary practice location

18510 N Parkview PL
Surprise, AZ 85374-4294

Mailing address

14722 W Laurel LN
Surprise, AZ 85379-6309
Phone (708) 220-2230

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210728001733 AZ Practitioner - Occupational Therapist in Private Practice 6103229166 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Empowerme Rehabilitation LLCGroup PAC ID 2769723162, 423 clinicians

Practice addresses (Care Compare)

9000 E San Victor Dr
Scottsdale, AZ 85258-5051
Phone (623) 299-7784

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OTH-007437AZMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Healthcare Services Inc Occupational Therapist CurrentSince Jul 22, 2021 Accepting new patients
Legacy Healthcare Services Inc Occupational Therapist CurrentSince Jul 22, 2021 Accepting new patients
Empowerme Rehabilitation, LLC Occupational Therapist CurrentSince Feb 1, 2024 Accepting new patients
Empowerme Rehabilitation, LLC Occupational Therapist CurrentSince Feb 1, 2024 Accepting new patients

Locations

1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 673-6723

110 Horizon Dr
#310
Raleigh, NC 27615

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": "1625702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625702400000",
    "number": "1164093266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14722 W LAUREL LN",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853796309",
            "telephone_number": "708-220-2230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18510 N PARKVIEW PL",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853744294",
            "telephone_number": "623-244-4482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THUESON",
        "first_name": "MADELINE",
        "middle_name": "GRACE",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-08",
        "last_updated": "2021-07-08",
        "certification_date": "2021-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AZ",
            "license": "OTH-007437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Surprise, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2021; 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.