Individual provider Active NPI

Elizabeth A. Jenson, MS, OTR/L, CHT

  • Occupational Therapist
  • Issaquah, WA
National Provider Identifier
1356762793
Registry record updated Jul 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT60270909 Issued in WA
Practice address
510 8TH Ave NE Ste 340
Issaquah, WA 98029-5449
Phone
(425) 313-3055
Fax
(425) 313-3051
NPI assigned
Jan 3, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hand Occupational Therapist 225XH1200X OT60270909 WA
Occupational Therapist 225X00000X OT60270909 WA Primary

Addresses

Primary practice location

510 8TH Ave NE Ste 340
Issaquah, WA 98029-5449

Mailing address

510 8TH Ave NE Ste 320
Issaquah, WA 98029-5436
Phone (425) 313-3055

Other identifiers 1

IdentifierTypeStateIssuer
2045365MedicaidWA

Other names 1

  • Elizabeth A. Sipma Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151002002494 WA Practitioner - Occupational Therapist in Private Practice 0446568877 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

26837 Maple Valley Black Diamond Rd
Suite 200
Maple Valley, WA 98038-9917
Phone (425) 413-4425

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
OT60270909WAMDHand Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Highline Physical Therapy Group Occupational Therapist CurrentSince Jul 6, 2015 Accepting new patients
Proliance Surgeons Inc P S Current Accepting new patients
Proliance Surgeons Inc P S CurrentSince Jul 20, 2020 Accepting new patients
Highline Physical Therapy Group Occupational Therapist CurrentSince Jul 6, 2015 Accepting new patients
Proliance Surgeons Inc., P.S. Occupational Therapist CurrentSince Jul 20, 2020 Accepting new patients
Outpatient Physical Therapy & Sports Rehabilitation Inc PC CurrentSince Jun 24, 2024 Accepting new patients

Locations

1200 112th Ave NE
Ste C260
Bellevue, WA 98004
Phone (425) 313-3055

16259 Sylvester Rd SW
Burien, WA 98166
Phone (206) 241-5400

510 8th Ave NE
Ste 340
Issaquah, WA 98029
Phone (425) 313-3051

510 8th Ave NE
Ste 320
Issaquah, WA 98029

8009 S 180th St
Ste 112
Kent, WA 98032
Phone (253) 833-8766

26837 Maple Valley Black Diamond Rd SE
Ste 200
Maple Valley, WA 98038
Phone (425) 413-4425

805 Madison St
Ste 901
Seattle, WA 98104
Phone (206) 264-8100

13050 Military Rd S
Tukwila, WA 98168
Phone (206) 248-3080

Organizations & group practices 6

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": "1388707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595462400000",
    "number": "1356762793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 8TH AVE NE STE 320",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980295436",
            "telephone_number": "425-313-3055",
            "fax_number": "425-313-3051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 8TH AVE NE STE 340",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980295449",
            "telephone_number": "425-313-3055",
            "fax_number": "425-313-3051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSON",
        "first_name": "ELIZABETH",
        "middle_name": "A.",
        "credential": "MS, OTR/L, CHT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-03",
        "last_updated": "2020-07-23",
        "certification_date": "2020-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "WA",
            "license": "OT60270909",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WA",
            "license": "OT60270909",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2045365",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "SIPMA",
            "middle_name": "A.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Issaquah, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2020; 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.