Individual provider Active NPI

Madison Gwinn Kalski, OTD, OTR/L

  • Occupational Therapist
  • San Diego, CA
National Provider Identifier
1356162473
Registry record updated Oct 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT25016 Issued in CA
Practice address
13223 Black Mountain Rd # 1508
San Diego, CA 92129-2698
Phone
(540) 623-0231
NPI assigned
Oct 21, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2024

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
Occupational Therapist 225X00000X OT25016 CA Primary

Addresses

Primary practice location

13223 Black Mountain Rd # 1508
San Diego, CA 92129-2698

Mailing address

10332 Wisteria Dr
Fredericksburg, VA 22408-8065

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
OT25016CAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1729468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729468800000",
    "number": "1356162473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10332 WISTERIA DR",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224088065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13223 BLACK MOUNTAIN RD # 1508",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921292698",
            "telephone_number": "540-623-0231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALSKI",
        "first_name": "MADISON",
        "middle_name": "GWINN",
        "name_prefix": "Dr.",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-21",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "OT25016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.