Sukanta Richard Nelson, OTD, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

523004 Issued in OR

Practice address

1805 SE 61St CT
Hillsboro, OR 97123-2919

Phone

(503) 778-0354

NPI assigned

Oct 30, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prestige Rehab Or LLCGroup PAC ID 5890219919, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Prestige Rehab Or LLC

  • Physical Therapy Clinic/Center
  • Portland, OR
  • NPI 1568277721
  Medicare reassignment Care Compare group NPD
• Healthpro Heritage Rehab & Fitness, LLC

  • Physical Therapist
  • Dallas, OR
  • NPI 1376272732

  Occupational Therapist

  Medicare reassignment NPD
• Healthpro Heritage Rehab & Fitness, LLC

  • Physical Therapist
  • Independence, MO
  • NPI 1871072462

  Occupational Therapist

  NPD

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

{
    "created_epoch": "1730246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1396567228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1805 SE 61ST CT",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971232919",
            "telephone_number": "503-778-0354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 SE 61ST CT",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971232919",
            "telephone_number": "503-778-0354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "SUKANTA",
        "middle_name": "RICHARD",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-10-30",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OR",
            "license": "523004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Jaime Nelson, MSW
• Jay Michael Nelson, LMT, CADCI
• Jennifer Penfield Nelson, P.A.
• Justin Nelson, DMD
• Michelle Nelson, MS CCC-SLP
• William Thomas Nelson, BA, MA
• Beeta Meagan Neshati
• Tira Elizabeth Nesset, FNP
• Valerie Netherland, N.D., L.AC.
• Neurotherapeutic Pediatric Therapies Inc

• Occupational Therapist in Hillsboro, OR
• Providers in Hillsboro, OR by specialty
• Occupational Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2024; 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.