Aileen Deogracias, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT 004155 Issued in GA

Practice address

4230 Grand Teton Pkwy
Suwanee, GA 30024-3096

Phone

(770) 568-1099

NPI assigned

Jul 11, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Sundance Rehabilitation Agency, LLC

  • Rehabilitation Clinic/Center
  • Athens, GA
  • NPI 1508281411
  NPD (past)

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

{
    "created_epoch": "1405036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440979200000",
    "number": "1396152237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4230 GRAND TETON PKWY",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300243096",
            "telephone_number": "770-568-1099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4230 GRAND TETON PKWY",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300243096",
            "telephone_number": "770-568-1099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEOGRACIAS",
        "first_name": "AILEEN",
        "name_prefix": "Ms.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-11",
        "last_updated": "2015-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT 004155",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "9136",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEORGIA STATE BOARD OF OCCUPATIONAL THERAPY",
            "identifier": "OT004155",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dental Sleep Therapy LLC
• Dentistry 4 You LLC
• Dentistry at Suwanee, P.C.
• Dentistry for Children of Suwanee, LLC
• Dentistry of Suwanee
• Katelyn Derogatis, LPC, NCC
• Ami Desai, DMD
• Mausami Desai
• Nikita Desai, MD
• Nutan Desai, O.D.

• Occupational Therapist in Suwanee, GA
• Providers in Suwanee, GA by specialty
• Occupational Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2015; 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.