Virgilio Pasa Querubin

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

1016 Issued in OK

Practice address

105 N 5TH Ave
Madill, OK 73446-1203

Phone

(580) 795-3301

Fax

(580) 795-7307

NPI assigned

Feb 18, 2008

Sex

Male

Sole proprietor

Yes

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 NY

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Speechwise SLP PLLCGroup PAC ID 2668761826, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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.

• Speechwise SLP PLLC

  • Speech-Language Pathologist
  • Goshen, NY
  • NPI 1548622210
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1203292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203292800000",
    "number": "1396913935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 831",
            "city": "MADILL",
            "state": "OK",
            "postal_code": "734460831",
            "telephone_number": "580-795-3301",
            "fax_number": "580-795-7307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 N 5TH AVE",
            "city": "MADILL",
            "state": "OK",
            "postal_code": "734461203",
            "telephone_number": "580-795-3301",
            "fax_number": "580-795-7307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUERUBIN",
        "first_name": "VIRGILIO",
        "middle_name": "PASA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-02-18",
        "last_updated": "2008-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "OK",
            "license": "1016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Dawn Pitman
• Crystal Dawn Pittman, REGISTERED NURSE
• Project Impact Oklahoma LLC
• Providence Service Corporation of Oklahoma
• Providence Service Corporation of Oklahoma
• Jami Rains
• Red River Rehabilitation Inc
• Red River Rehabilitation, Inc.
• Stacy James Rendon, COTA
• Kaitlyn Richardson

• Occupational Therapy Assistant in Madill, OK
• Providers in Madill, OK by specialty
• Occupational Therapy Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2008; 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.