Individual provider Active NPI

Susan Zekert Hundsdorfer, OTR, CLVT

  • Occupational Therapist
  • Boulder, CO
National Provider Identifier
1366565715
Registry record updated Jan 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
CO HAS NO OT LICENSE Issued in CO
Practice address
610 S 40TH St
Boulder, CO 80305-5905
Phone
(303) 543-0669
Fax
(303) 494-0530
NPI assigned
Apr 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2012

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 CO HAS NO OT LICENSE CO Primary

Addresses

Primary practice location

610 S 40TH St
Boulder, CO 80305-5905

Mailing address

610 S 40TH St
Boulder, CO 80305-5905
Phone (303) 543-0669

Other identifiers 4

IdentifierTypeStateIssuer
15297957OtherCOWITHHOLD LIC-EYEONLIVING
665829002001OtherCOUNEMP INS TAXIDEYEONLIVIN
63180855MedicaidCO
969623OtherNATL BOARD FOR CERT IN OT

Other names 1

  • Susan Zekert Professional 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)
Enrolled

State licenses

LicenseStateTypeSpecialty
CO HAS NO OT LICENSECOMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Eye on Living, Inc. Occupational Therapist PastSince Jan 1, 1990 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": "1176076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326067200000",
    "number": "1366565715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 S 40TH ST",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803055905",
            "telephone_number": "303-543-0669",
            "fax_number": "303-494-0530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 S 40TH ST",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803055905",
            "telephone_number": "303-543-0669",
            "fax_number": "303-494-0530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUNDSDORFER",
        "first_name": "SUSAN",
        "middle_name": "ZEKERT",
        "credential": "OTR, CLVT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-09",
        "last_updated": "2012-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CO",
            "license": "CO HAS NO OT LICENSE",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WITHHOLD LIC-EYEONLIVING",
            "identifier": "15297957",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNEMP INS TAXIDEYEONLIVIN",
            "identifier": "665829002001",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "63180855",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATL BOARD FOR CERT IN OT",
            "identifier": "969623",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "ZEKERT",
            "credential": "OTR, CLVT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Boulder, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2012; 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.