Mark Dejesus, O.T.

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

1701739 Issued in KS

Practice address

623 Commercial St
Emporia, KS 66801-3901

Phone

(620) 803-1855

Fax

(620) 208-4488

NPI assigned

May 25, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KS

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

At Still Un of HLTH Sciences, Col of Osteo Med, Mesa, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Emporia Myofascial Care3

  • Occupational Therapist
  • Emporia, KS
  • NPI 1306569660
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740096000000",
    "number": "1225249642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "623 COMMERCIAL ST",
            "city": "EMPORIA",
            "state": "KS",
            "postal_code": "668013901",
            "telephone_number": "620-803-1855",
            "fax_number": "620-208-4488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "623 COMMERCIAL ST",
            "city": "EMPORIA",
            "state": "KS",
            "postal_code": "668013901",
            "telephone_number": "620-803-1855",
            "fax_number": "620-208-4488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEJESUS",
        "first_name": "MARK",
        "name_prefix": "Mr.",
        "credential": "O.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-25",
        "last_updated": "2025-02-21",
        "certification_date": "2025-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "KS",
            "license": "1701739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Felicia Davidson
• Laura Erin Davis, CPTA
• Robert Lyle Davis, CRNA
• Tracey L Davis, LSCSW
• Eugene Francis Dedonder, R.PH.
• Macey Delong
• Dale R Denney, LSCSW
• Christopher Alexander Denton
• Todd M Detwiler, MD
• Tara Deweerdt

• Occupational Therapist in Emporia, KS
• Providers in Emporia, KS by specialty
• Occupational Therapist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2025; 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.