Individual provider Active NPI

Boruch Wilansky

  • Occupational Therapist
  • Las Vegas, NV
National Provider Identifier
1346029683
Registry record updated Sep 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT-3327 Issued in NV
Practice address
9100 W Desert Inn Rd
Las Vegas, NV 89117-6323
Phone
(702) 472-8505
NPI assigned
Sep 26, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 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 OT-3327 NV Primary

Addresses

Primary practice location

9100 W Desert Inn Rd
Las Vegas, NV 89117-6323

Mailing address

8437 Squaw Valley Ave
Las Vegas, NV 89128-7619
Phone (929) 391-0668

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231017001921 NV Practitioner - Occupational Therapist in Private Practice 0345695995 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Pediatric Therapy LLC Occupational Therapist CurrentSince Nov 1, 2024 Accepting new patients
Occutherapy, LLC Occupational Therapist CurrentSince Nov 17, 2024 Accepting new patients
Savvy Speech Therapist LLC Occupational Therapist CurrentSince Aug 25, 2024 Accepting new patients

Locations

1820 E Warm Springs Rd
Ste 130
Las Vegas, NV 89119

4680 Polaris Ave
Ste 200
Las Vegas, NV 89103
Phone (702) 909-5900

1017 S Cimarron Rd
Las Vegas, NV 89145
Phone (702) 640-0631

Organizations & group practices 3

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": "1695686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1346029683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8437 SQUAW VALLEY AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891287619",
            "telephone_number": "929-391-0668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9100 W DESERT INN RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891176323",
            "telephone_number": "702-472-8505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILANSKY",
        "first_name": "BORUCH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-26",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NV",
            "license": "OT-3327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2023; 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.

Verify at the official NPI Registry.