Active NPI
Kelly Boyle
- Occupational Therapist
- Long Beach, CA
National Provider Identifier
1295242261
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT18074
- Practice address
- 328 Eliot LN
Long Beach, CA 90814-3117 - Phone
- (720) 218-5838
- NPI assigned
- Dec 29, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT18074 | CA | Primary |
Addresses
Primary practice location
328 Eliot LN
Long Beach, CA 90814-3117
Mailing address
328 Eliot LN
Long Beach, CA 90814-3117
Phone (720) 218-5838
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180112002081 | CA | Practitioner - Occupational Therapist in Private Practice | 4981963212 | Practice locations: Long Beach, CA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT18074 | CA | MD | Occupational Therapist |
| 18074 | CA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Silver Bear OT Services | Occupational Therapist | Current | Accepting new patients |
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 and National Provider Directory roles.
-
- Occupational Therapist
- Long Beach, CA
- NPI 1790647154
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1514505600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1741737600000",
"number": "1295242261",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "328 ELIOT LN",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908143117",
"telephone_number": "720-218-5838"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "328 ELIOT LN",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908143117",
"telephone_number": "720-218-5838"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOYLE",
"first_name": "KELLY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-12-29",
"last_updated": "2025-03-12",
"certification_date": "2025-03-12",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "OT18074",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Long Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.