NPIMap

Individual provider Active NPI

Karen Mycanka, OTR CHT CLT

  • Hand Occupational Therapist
  • Excelsior Springs, MO
National Provider Identifier
1376501684
Registry record updated Jun 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hand Occupational TherapistTaxonomy code 225XH1200X
License
9811000110 Issued in MO
Practice address
1700 Rainbow Blvd
Excelsior Springs, MO 64024-1182
Phone
(816) 629-2700
Fax
(816) 629-2723
NPI assigned
May 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 000014 MO
Occupational Therapist 225X00000X 000014 MO
Hand Occupational Therapist 225XH1200X 9811000110 MO Primary

Addresses

Primary practice location

1700 Rainbow Blvd
Excelsior Springs, MO 64024-1182

Mailing address

1700 Rainbow Boulevard
Excelsior Springs, MO 64024
Phone (816) 629-2700

Other identifiers 1

IdentifierTypeStateIssuer
20217047OtherMOBCBS

Other names 1

  • Karen Lelito 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)
Enrolled

State licenses

LicenseStateTypeSpecialty
000014MOMDSpecialist
9811000110MOMDHand Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
US PT Therapy Services Inc. Past Accepting new patients
US PT Turnkey Services Inc. Hand Past Accepting new patients
Cancer Rehabilitation Specialists Lymphatic and Venous Disorders Inc Occupational Therapist PastSince Dec 1, 2001 Accepting new patients

Organizations & group practices 3

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": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371600000000",
    "number": "1376501684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 RAINBOW BOULEVARD",
            "city": "EXCELSIOR SPRINGS",
            "state": "MO",
            "postal_code": "64024",
            "telephone_number": "816-629-2700",
            "fax_number": "816-629-2723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 RAINBOW BLVD",
            "city": "EXCELSIOR SPRINGS",
            "state": "MO",
            "postal_code": "640241182",
            "telephone_number": "816-629-2700",
            "fax_number": "816-629-2723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYCANKA",
        "first_name": "KAREN",
        "name_prefix": "Mrs.",
        "credential": "OTR CHT CLT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-03",
        "last_updated": "2013-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MO",
            "license": "000014",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MO",
            "license": "000014",
            "primary": false
        },
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "MO",
            "license": "9811000110",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "20217047",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAREN",
            "last_name": "LELITO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Excelsior Springs, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2013; 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.