Individual provider Active NPI

Mathew Samkutty, OCCUPATIONAL THERAPI

  • Occupational Therapist
  • Milwaukie, OR
National Provider Identifier
1306937826
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
1023500 Issued in OR
Practice address
4560 SE International Way
Consonus Rehab Services
Milwaukie, OR 97222
Phone
(971) 206-5140
Fax
(971) 206-5209
NPI assigned
Sep 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 1023500 OR Primary

Addresses

Primary practice location

4560 SE International Way
Consonus Rehab Services
Milwaukie, OR 97222

Mailing address

4560 SE International Way
Milwaukie, OR 97222
Phone (971) 206-5140

Other identifiers 1

IdentifierTypeStateIssuer
274812OtherOROMAP

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251024003225 IL Practitioner - Occupational Therapist in Private Practice 1557859014 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1997
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1335 Stranssner Dr
Brentwood, MO 63144-1872

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1023500ORMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Empowerme Rehabilitation Illinois, LLC Occupational Therapist CurrentSince Oct 10, 2025 Accepting new patients
Empowerme Wellness Kansas City, LLC CurrentSince Oct 10, 2025 Accepting new patients
Empowerme Wellness Kansas City, LLC Occupational Therapist CurrentSince Oct 10, 2025 Accepting new patients
Empowerme Rehabilitation Illinois, LLC Occupational Therapist CurrentSince Oct 10, 2025 Accepting new patients

Locations

1021 W E St
Belleville, IL 62220
Phone (618) 233-2095

7108 Marine Rd
Edwardsville, IL 62025
Phone (618) 706-9759

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

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306937826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4560 SE INTERNATIONAL WAY",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "97222",
            "telephone_number": "971-206-5140",
            "fax_number": "971-206-5209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4560 SE INTERNATIONAL WAY",
            "address_2": "CONSONUS REHAB SERVICES",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "97222",
            "telephone_number": "971-206-5140",
            "fax_number": "971-206-5209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMKUTTY",
        "first_name": "MATHEW",
        "credential": "OCCUPATIONAL THERAPI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OR",
            "license": "1023500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OMAP",
            "identifier": "274812",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukie, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.