Individual provider Active NPI

Paola Andrea Pinto, OTR

  • Occupational Therapist
  • Normal, IL
National Provider Identifier
1366728669
Registry record updated Oct 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056.012521 Issued in IL
Practice address
509 N Adelaide St
Normal, IL 61761-2422
Phone
(309) 452-7468
NPI assigned
Oct 31, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2021

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 13553 FL
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X 056.012521 IL Primary

Addresses

Primary practice location

509 N Adelaide St
Normal, IL 61761-2422

Mailing address

2803 Luke Rd
Bloomington, IL 61704-7032
Phone (786) 443-1070

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
13553FLMDOccupational Therapist
056.012521ILMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1320019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633910400000",
    "number": "1366728669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2803 LUKE RD",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617047032",
            "telephone_number": "786-443-1070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 N ADELAIDE ST",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617612422",
            "telephone_number": "309-452-7468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PINTO",
        "first_name": "PAOLA",
        "middle_name": "ANDREA",
        "name_prefix": "Mrs.",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-31",
        "last_updated": "2021-10-11",
        "certification_date": "2021-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "13553",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056.012521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Normal, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2021; 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.