Individual provider Active NPI

Ellen Olefsky

  • Occupational Therapist
  • Ada, MI
National Provider Identifier
1417009853
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5201007104 Issued in MI
Practice address
6698 Adaridge Dr SE
Ada, MI 49301-9139
Phone
(616) 450-1843
NPI assigned
Jan 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 5201007104 MI Primary

Addresses

Primary practice location

6698 Adaridge Dr SE
Ada, MI 49301-9139

Mailing address

3977 Clearview St NE
Grand Rapids, MI 49546-1332
Phone (616) 780-3404

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070425000012 MI Practitioner - Occupational Therapist in Private Practice 1759486475 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Physical Rehabilitation and Therapy LP CurrentSince Jan 27, 2019 Accepting new patients
Center for Physical Rehabilitation Inc Past Accepting new patients
Scharich I Rehab Services LLC Occupational Therapist Past Accepting new patients

Locations

5060 Cascade Rd SE
Ste A
Grand Rapids, MI 49546
Phone (616) 954-0950

901 W Main St
Lowell, MI 49331
Phone (616) 897-7055

Organizations & group practices 3

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": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417009853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3977 CLEARVIEW ST NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495461332",
            "telephone_number": "616-780-3404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6698 ADARIDGE DR SE",
            "city": "ADA",
            "state": "MI",
            "postal_code": "493019139",
            "telephone_number": "616-450-1843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLEFSKY",
        "first_name": "ELLEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201007104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ada, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.