Keanne Alysse Prollamante, OTD, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Practice address

2401 W Horizon Ridge Pkwy Ste 100
Henderson, NV 89052-2707

Phone

(702) 458-1300

NPI assigned

Nov 19, 2024

Sex

Female

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 NV

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Affiliated Physical TherapyGroup PAC ID 1951453075, 47 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Affiliated Physical Therapy

  • Physical Therapist
  • North Las Vegas, NV
  • NPI 1669607156

  Occupational Therapist

  Medicare reassignment Care Compare group NPD
• Therapy West LLC

  • Physical Therapist
  • Las Vegas, NV
  • NPI 1972168540
  NPD (past)

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

{
    "created_epoch": "1731974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1255156782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11215 GAMMILA DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891410435",
            "telephone_number": "702-378-6741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 W HORIZON RIDGE PKWY STE 100",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890522707",
            "telephone_number": "702-458-1300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROLLAMANTE",
        "first_name": "KEANNE",
        "middle_name": "ALYSSE",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-19",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shirley Prodoehl
• Professional Authorization Claim Service
• Professional in-Home Care Agency
• Project Life
• Chelsea Prollamante
• Proud Moments ABA of Nevada LLC
• Jennifer Provenzano
• Katelin Provost, LCSW
• Zdenka Prus, MA, LCPC
• Sonia Prusinski

• Occupational Therapist in Henderson, NV
• Providers in Henderson, NV by specialty
• Occupational Therapist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 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.