Individual provider Active NPI

Pankaj K Tyagi, OTR

  • Occupational Therapist
  • Terre Haute, IN
National Provider Identifier
1205886967
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
31001448A Issued in IN
Practice address
4417 S Hidden Way St
Terre Haute, IN 47802-6602
Phone
(812) 201-1338
NPI assigned
May 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 31001448A IN Primary

Addresses

Primary practice location

4417 S Hidden Way St
Terre Haute, IN 47802-6602

Mailing address

4417 S Hidden Way St
Terre Haute, IN 47802-6602
Phone (812) 201-1338

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040720001206 IN Practitioner - Occupational Therapist in Private Practice 1951381185 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

650 Lafayette Ave
Terre Haute, IN 47807-1839
Phone (930) 348-1714

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
31001448AINMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Healthpro Heritage Rehab & Fitness, LLC Occupational Therapist CurrentSince Jul 31, 2023 Accepting new patients
Healthpro Heritage Rehab & Fitness, LLC Occupational Therapist CurrentSince Jul 31, 2023 Accepting new patients
TCP Management Past Accepting new patients
Net Med Supply Occupational Therapist PastSince Jun 1, 2007 Accepting new patients
Apex Therapy Services, LLC Past Accepting new patients

Organizations & group practices 5

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": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1205886967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4417 S HIDDEN WAY ST",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478026602",
            "telephone_number": "812-201-1338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4417 S HIDDEN WAY ST",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478026602",
            "telephone_number": "812-201-1338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYAGI",
        "first_name": "PANKAJ",
        "middle_name": "K",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IN",
            "license": "31001448A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Terre Haute, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.