Individual provider Active NPI

Michelle Gaeta, OTR

  • Hand Occupational Therapist
  • Louisville, KY
National Provider Identifier
1336269760
Registry record updated Aug 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hand Occupational TherapistTaxonomy code 225XH1200X
License
OT-10219 Issued in FL
Practice address
9880 Angies Way Ste 100
Louisville, KY 40241-2851
Phone
(502) 339-6490
NPI assigned
Mar 30, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 174429 KY
Hand Occupational Therapist 225XH1200X OT-10219 FL Primary

Addresses

Primary practice location

9880 Angies Way Ste 100
Louisville, KY 40241-2851

Mailing address

3175 Clore Jackson Rd
Shelbyville, KY 40065-9078
Phone (732) 796-3257

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Shelbyville Other

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190829002633 KY Practitioner - Occupational Therapist in Private Practice 1951376854 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
SN Kentuckiana Rehab, LLCGroup PAC ID 1254671464, 339 clinicians

Practice addresses (Care Compare)

9880 Angies Way
Suite 100
Louisville, KY 40241-2851
Phone (502) 339-6490

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT-10219FLMDHand Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
SN Kentuckiana Rehab, LLC CurrentSince Jul 10, 2019 Accepting new patients
SN Kentuckiana Rehab, LLC Current Accepting new patients
SN Kentuckiana Rehab, LLC CurrentSince Jul 10, 2019 Accepting new patients
Gold Coast Physical Therapy Associates LLC Past Accepting new patients
Rehabsystems Physical Therapy Centers, Inc. Past Accepting new patients

Locations

315 E Broadway
Ste 195
Louisville, KY 40202
Phone (502) 589-5961

2152 S Hurstbourne Pkwy
Louisville, KY 40220
Phone (502) 349-6961

210 E Gray St
Ste 807
Louisville, KY 40202
Phone (502) 587-9350

12000 Aiken Rd
Louisville, KY 40243
Phone (502) 489-5002

9880 Angies Way
Ste 100
Lyndon, KY 40241
Phone (502) 209-0649

190 Shadowmeade Ln
Mt Washington, KY 40047
Phone (502) 538-2332

160 Frankfort Rd
Shelbyville, KY 40065
Phone (502) 257-8452

4420 Dixie Hwy
Ste 122
Shively, KY 40216
Phone (502) 447-2750

Organizations & group practices 5

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": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564617600000",
    "number": "1336269760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3175 CLORE JACKSON RD",
            "city": "SHELBYVILLE",
            "state": "KY",
            "postal_code": "400659078",
            "telephone_number": "732-796-3257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9880 ANGIES WAY STE 100",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402412851",
            "telephone_number": "502-339-6490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAETA",
        "first_name": "MICHELLE",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-30",
        "last_updated": "2019-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "KY",
            "license": "174429",
            "primary": false
        },
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "FL",
            "license": "OT-10219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Shelbyville",
            "affiliation": "N",
            "endpointDescription": "xxxx",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Shelbyville",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Shelbyville",
            "address_1": "9880 Angies Way Ste 100",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402412851",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 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.