Individual provider Active NPI

Lisa Barry Gofberg, OTR

  • Hand Occupational Therapist
  • Thousand Oaks, CA
National Provider Identifier
1255315966
Registry record updated Sep 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hand Occupational TherapistTaxonomy code 225XH1200X
License
707 Issued in CA
Practice address
550 Saint Charles Dr
Suite 100
Thousand Oaks, CA 91360-3951
Phone
(805) 449-1125
Fax
(805) 449-4113
NPI assigned
Dec 6, 2005
Last updated
Sep 24, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hand Occupational Therapist 225XH1200X 707 CA Primary

Addresses

Primary practice location

550 Saint Charles Dr
Suite 100
Thousand Oaks, CA 91360-3951

Mailing address

550 Saint Charles Dr
Suite 100
Thousand Oaks, CA 91360-3951
Phone (805) 449-1125

Other names 1

  • Mrs. Lisa Barry Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050921000370 CA Practitioner - Occupational Therapist in Private Practice 4981638897 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Meridian Hand Therapy, IncGroup PAC ID 1456385368, 6 clinicians

Practice addresses (Care Compare)

550 Saint Charles Dr
Suite 100
Thousand Oaks, CA 91360-3969
Phone (805) 449-1125

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
707CAMDNaturopath

Practice roles

OrganizationSpecialtyStatusNew patients
Meridian Hand Therapy Inc Hand CurrentSince Sep 6, 2005 Accepting new patients
Meridian Hand Therapy Inc Hand CurrentSince Feb 14, 2005 Accepting new patients

Locations

18911 Nordhoff St
Ste 37
Northridge, CA 91324
Phone (818) 435-2800

550 Saint Charles Dr
Ste 100
Thousand Oaks, CA 91360
Phone (805) 449-1125

696 Hampshire Rd
Ste 180A
Westlake Village, CA 91361
Phone (805) 497-1700

Organizations & group practices 2

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": "1133827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222214400000",
    "number": "1255315966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 SAINT CHARLES DR",
            "address_2": "SUITE 100",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913603951",
            "telephone_number": "805-449-1125",
            "fax_number": "805-449-4113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 SAINT CHARLES DR",
            "address_2": "SUITE 100",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913603951",
            "telephone_number": "805-449-1125",
            "fax_number": "805-449-4113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARRY GOFBERG",
        "first_name": "LISA",
        "name_prefix": "Mrs.",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-06",
        "last_updated": "2008-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "CA",
            "license": "707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "BARRY",
            "prefix": "MRS.",
            "credential": "OTR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Thousand Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2008; 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.