Individual provider Active NPI

Susan Marie Hurley, OTR

  • Hand Occupational Therapist
  • Yucca Valley, CA
National Provider Identifier
1356494074
Registry record updated Sep 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hand Occupational TherapistTaxonomy code 225XH1200X
License
OT 5196 Issued in CA
Practice address
56299 29 Palms Hwy
Yucca Valley, CA 92284-2857
Phone
(760) 369-1743
Fax
(760) 365-6934
NPI assigned
Jan 18, 2007
Last updated
Sep 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hand Occupational Therapist 225XH1200X OT 5196 CA Primary

Addresses

Primary practice location

56299 29 Palms Hwy
Yucca Valley, CA 92284-2857

Mailing address

32790 Navajo TRL
Cathedral City, CA 92234-4075
Phone (760) 369-1743

Other identifiers 3

IdentifierTypeStateIssuer
OT0051960OtherCABLUE SHIELD
72157585392277A004OtherCATRICARE
CT3786610MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040401001769 CA Practitioner - Occupational Therapist in Private Practice 2567454150 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
H D P R G IncGroup PAC ID 3678465564, 16 clinicians

Practice addresses (Care Compare)

56299 29 Palms Hwy
Yucca Valley, CA 92284-2857
Phone (760) 369-1743

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT 5196CAMDHand Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
H.D.P.R.G., Inc CurrentSince Jan 1, 2004 Accepting new patients

Locations

5930 Adobe Rd
Twentynine Palms, CA 92277
Phone (760) 367-1743

56299 29 Palms Hwy
Yucca Valley, CA 92284
Phone (760) 367-1743

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1356494074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32790 NAVAJO TRL",
            "city": "CATHEDRAL CITY",
            "state": "CA",
            "postal_code": "922344075",
            "telephone_number": "760-369-1743",
            "fax_number": "760-365-6934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56299 29 PALMS HWY",
            "city": "YUCCA VALLEY",
            "state": "CA",
            "postal_code": "922842857",
            "telephone_number": "760-369-1743",
            "fax_number": "760-365-6934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HURLEY",
        "first_name": "SUSAN",
        "middle_name": "MARIE",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-18",
        "last_updated": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "CA",
            "license": "OT 5196",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "OT0051960",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "72157585392277A004",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CT3786610",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yucca Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; 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.