Individual provider Active NPI

Khusbu Sheth

  • Occupational Therapist
  • Buffalo Grove, IL
National Provider Identifier
1255984605
Registry record updated Mar 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Practice address
1131 McHenry Rd Ste 107a
Buffalo Grove, IL 60089-1369
Phone
(847) 305-1097
NPI assigned
Jul 24, 2019
Last updated
Mar 17, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X Primary

Addresses

Primary practice location

1131 McHenry Rd Ste 107a
Buffalo Grove, IL 60089-1369

Mailing address

703 S Jade LN
Round Lake, IL 60073-8165
Phone (224) 217-0113

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230906001731 IL Practitioner - Occupational Therapist in Private Practice 8123481322 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Nova Southeastern College of Osteo Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
KG Therapy PLLCGroup PAC ID 1951764158, 3 clinicians

Practice addresses (Care Compare)

1131 McHenry Rd
Suite 107
Buffalo Grove, IL 60089-1369
Phone (847) 305-1097

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
KG Therapy PLLC CurrentSince Jun 21, 2023 Accepting new patients

Locations

1131 McHenry Rd
#107
Buffalo Grove, IL 60089
Phone (847) 305-1097

Organizations & group practices 1

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": "1563926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679011200000",
    "number": "1255984605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 S JADE LN",
            "city": "ROUND LAKE",
            "state": "IL",
            "postal_code": "600738165",
            "telephone_number": "224-217-0113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1131 MCHENRY RD STE 107A",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600891369",
            "telephone_number": "847-305-1097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHETH",
        "first_name": "KHUSBU",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-24",
        "last_updated": "2023-03-17",
        "certification_date": "2023-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo Grove, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2023; 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.