Individual provider Active NPI

Nicole M Bugielski, MOTR/L

  • Pediatric Occupational Therapist
  • San Diego, CA
National Provider Identifier
1356653588
Registry record updated May 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
20088 Issued in CA
Practice address
2627 W Canyon Ave Apt 527
San Diego, CA 92123-4708
Phone
(708) 612-8364
NPI assigned
Jul 2, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 20088 CA Primary

Addresses

Primary practice location

2627 W Canyon Ave Apt 527
San Diego, CA 92123-4708

Mailing address

2627 W Canyon Ave Apt 527
San Diego, CA 92123-4708
Phone (708) 612-8364

Other names 1

  • Nicole M Balogh Former name

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
20088CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kids First Therapy, LLC Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1278028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715731200000",
    "number": "1356653588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2627 W CANYON AVE APT 527",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234708",
            "telephone_number": "708-612-8364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2627 W CANYON AVE APT 527",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234708",
            "telephone_number": "708-612-8364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUGIELSKI",
        "first_name": "NICOLE",
        "middle_name": "M",
        "credential": "MOTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-02",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "CA",
            "license": "20088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "BALOGH",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 May 15, 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.