Individual provider Active NPI

Mark Gitau

  • Occupational Therapist
  • Kansas City, MO
National Provider Identifier
1235471152
Registry record updated Apr 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
2009012407 Issued in MO
Practice address
6460 N Cosby Ave
Kansas City, MO 64151-2301
Phone
(316) 992-6442
NPI assigned
Mar 18, 2013
Last updated
Apr 11, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 2009012407 MO Primary
Physical Rehabilitation Occupational Therapist 225XP0019X 17-02467 KS

Addresses

Primary practice location

6460 N Cosby Ave
Kansas City, MO 64151-2301

Mailing address

4425 Cambridge St
Kansas City, KS 66103-3505
Phone (316) 992-6442

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251007004083 MO Practitioner - Occupational Therapist in Private Practice 6800175753 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Healthcare Services IncGroup PAC ID 2163339722, 3,431 clinicians

Practice addresses (Care Compare)

6460 N Cosby Ave
Kansas City, MO 64151-2301
Phone (816) 746-7469

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2009012407MOMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Healthcare Services Inc Occupational Therapist CurrentSince Sep 1, 2025 Accepting new patients
Legacy Healthcare Services Inc. Occupational Therapist CurrentSince Sep 1, 2025 Accepting new patients

Locations

6921 W 81st St
Overland Park, KS 66204
Phone (913) 901-8500

15950 Manchester Rd
Ellisville, MO 63011
Phone (636) 220-2748

110 Horizon Dr
#310
Raleigh, NC 27615

Organizations & group practices 3

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": "1363564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712793600000",
    "number": "1235471152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4425 CAMBRIDGE ST",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661033505",
            "telephone_number": "316-992-6442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6460 N COSBY AVE",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641512301",
            "telephone_number": "316-992-6442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GITAU",
        "first_name": "MARK",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-03-18",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MO",
            "license": "2009012407",
            "primary": true
        },
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "KS",
            "license": "17-02467",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 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.