Individual provider Active NPI

Cristiane Carmo, OTR L

  • Pediatric Occupational Therapist
  • Valrico, FL
National Provider Identifier
1386600245
Registry record updated Jul 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
OT0003911 Issued in FL
Practice address
2530 Ridgetop Way
Valrico, FL 33594
Phone
(813) 684-9985
Fax
(813) 643-1387
NPI assigned
Apr 20, 2006
Last updated
Jul 3, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurorehabilitation Occupational Therapist 225XN1300X OT0003911 FL
Pediatric Occupational Therapist 225XP0200X OT0003911 FL Primary
Developmental Therapist 222Q00000X OT3911 FL

Addresses

Primary practice location

2530 Ridgetop Way
Valrico, FL 33594

Mailing address

2530 Ridgetop Way
Valrico, FL 33594-4223
Phone (813) 684-9985

Other identifiers 2

IdentifierTypeStateIssuer
889657700MedicaidFL
885541200MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161209000639 FL Practitioner - Occupational Therapist in Private Practice 0840570834 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1097 E Brandon Blvd
Brandon, FL 33511-5515
Phone (813) 684-9985

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT3911FLMDDevelopmental Therapist
OT0003911FLMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
True Blue Therapy LLC CurrentSince Dec 19, 2009 Accepting new patients

Locations

1097 E Brandon Blvd
Brandon, FL 33511
Phone (813) 404-4878

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530576000000",
    "number": "1386600245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2530 RIDGETOP WAY",
            "city": "VALRICO",
            "state": "FL",
            "postal_code": "335944223",
            "telephone_number": "813-684-9985",
            "fax_number": "813-643-1387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2530 RIDGETOP WAY",
            "city": "VALRICO",
            "state": "FL",
            "postal_code": "33594",
            "telephone_number": "813-684-9985",
            "fax_number": "813-643-1387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARMO",
        "first_name": "CRISTIANE",
        "credential": "OTR L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-20",
        "last_updated": "2018-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XN1300X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Neurorehabilitation",
            "state": "FL",
            "license": "OT0003911",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "FL",
            "license": "OT0003911",
            "primary": true
        },
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": "FL",
            "license": "OT3911",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "889657700",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "885541200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Valrico, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2018; 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.