Individual provider Active NPI

Khushboo Gajjar, OT

  • Pediatric Occupational Therapist
  • Glendale, AZ
National Provider Identifier
1255805495
Registry record updated Jan 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
OTH-007680 Issued in AZ
Practice address
20329 N 59TH Ave Ste A2
Glendale, AZ 85308-6854
Phone
(623) 594-0294
NPI assigned
Jan 21, 2019
Last updated
Jan 21, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X OTH-007680 AZ Primary

Addresses

Primary practice location

20329 N 59TH Ave Ste A2
Glendale, AZ 85308-6854

Mailing address

20329 N 59TH Ave Ste A2
Glendale, AZ 85308-6854
Phone (623) 594-0294

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200504000574 AZ Practitioner - Occupational Therapist in Private Practice 3072944206 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Empowerme Rehabilitation LLCGroup PAC ID 2769723162, 423 clinicians

Practice addresses (Care Compare)

9000 E San Victor Dr
Scottsdale, AZ 85258-5051
Phone (623) 299-7784

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OTH-007680AZMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Empowerme Rehabilitation, LLC Occupational Therapist CurrentSince Jan 1, 2025 Accepting new patients
Empowerme Rehabilitation, LLC Occupational Therapist CurrentSince Jan 1, 2025 Accepting new patients
Heartland Therapy, Inc. CurrentSince Apr 1, 2020 Accepting new patients
Theracare PLLC Occupational Therapist CurrentSince Apr 1, 2020 Accepting new patients
Therapy Tree, PLLC Pediatrics Past Accepting new patients
Therapy Tree Group PLLC PastSince Dec 13, 2022 Accepting new patients

Locations

2830 E Brown Rd
Ste 1
Mesa, AZ 85213
Phone (480) 830-1188

530 E McDowell Rd
Ste 107475
Phoenix, AZ 85004

1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 673-6723

Organizations & group practices 6

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": "1548028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548028800000",
    "number": "1255805495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20329 N 59TH AVE STE A2",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853086854",
            "telephone_number": "623-594-0294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20329 N 59TH AVE STE A2",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853086854",
            "telephone_number": "623-594-0294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAJJAR",
        "first_name": "KHUSHBOO",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-21",
        "last_updated": "2019-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "AZ",
            "license": "OTH-007680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2019; 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.