Individual provider Active NPI

Emily Brotnov, OTR/L

  • Physical Rehabilitation Occupational Therapist
  • Lewiston, ID
National Provider Identifier
1386507713
Registry record updated Dec 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Rehabilitation Occupational TherapistTaxonomy code 225XP0019X
License
2159 Issued in ID
Practice address
1209 3Rd St
Lewiston, ID 83501-2717
Phone
(509) 710-7499
NPI assigned
Dec 3, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Rehabilitation Occupational Therapist 225XP0019X 2159 ID Primary

Addresses

Primary practice location

1209 3Rd St
Lewiston, ID 83501-2717

Mailing address

1209 3Rd St
Lewiston, ID 83501-2717
Phone (509) 710-7499

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260203003159 WA Practitioner - Occupational Therapist in Private Practice 1052899655 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
University of Washington School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1620 SE Summit CT
Pullman, WA 99163-5519
Phone (509) 332-5106

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2159IDMDPhysical Rehabilitation Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Public Hospital District #1-a of Whitman County CurrentSince Mar 1, 2026 Accepting new patients
Public Hospital District #1-a of Whitman County Past Accepting new patients

Locations

1620 SE Summit Ct
Pullman, WA 99163
Phone (509) 332-5106

835 SE Bishop Blvd
Pullman, WA 99163
Phone (509) 332-2541

Organizations & group practices 2

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": "1764720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764720000000",
    "number": "1386507713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1209 3RD ST",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835012717",
            "telephone_number": "509-710-7499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1209 3RD ST",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835012717",
            "telephone_number": "509-710-7499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROTNOV",
        "first_name": "EMILY",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-03",
        "last_updated": "2025-12-03",
        "certification_date": "2025-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "ID",
            "license": "2159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewiston, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2025; 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.