Individual provider Active NPI

Zachary Kinzer, OCCUPATIONAL THERAPI

  • Occupational Therapist
  • Milwaukie, OR
National Provider Identifier
1437240967
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
1060073 Issued in OR
Practice address
4560 SE International Way
Consonus Rehab Services
Milwaukie, OR 97222
Phone
(971) 206-5140
Fax
(971) 206-5209
NPI assigned
Sep 28, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
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 1060073 OR Primary

Addresses

Primary practice location

4560 SE International Way
Consonus Rehab Services
Milwaukie, OR 97222

Mailing address

4560 SE International Way
Milwaukie, OR 97222
Phone (971) 206-5140

Other identifiers 2

IdentifierTypeStateIssuer
119133OtherOROTIP # MEDICARE PART B
182824OtherOROMAP #

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040623000755 OR Practitioner - Occupational Therapist in Private Practice 7416932322 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Select Rehabilitation, LLC Occupational Therapist CurrentSince Jan 9, 2024 Accepting new patients
Rehab Specialists Outpatient, LLC Occupational Therapist CurrentSince Nov 1, 2023 Accepting new patients
Rehab Specialists Outpatient, LLC Occupational Therapist CurrentSince Nov 1, 2023 Accepting new patients
Rehab Specialists I, LLC Occupational Therapist Past Accepting new patients

Locations

1010 NE Purcell Blvd
Bend, OR 97701
Phone (541) 318-6042

17309 NE Glisan St
Portland, OR 97230
Phone (503) 253-4920

4560 SE International Way
Portland, OR 97222
Phone (971) 206-5140

4560 SE International Way
Ste 100
Portland, OR 97222
Phone (971) 206-5129

9000 SW 91st Ave
Tigard, OR 97223
Phone (503) 445-4363

Organizations & group practices 4

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": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1437240967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4560 SE INTERNATIONAL WAY",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "97222",
            "telephone_number": "971-206-5140",
            "fax_number": "971-206-5209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4560 SE INTERNATIONAL WAY",
            "address_2": "CONSONUS REHAB SERVICES",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "97222",
            "telephone_number": "971-206-5140",
            "fax_number": "971-206-5209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINZER",
        "first_name": "ZACHARY",
        "credential": "OCCUPATIONAL THERAPI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OR",
            "license": "1060073",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTIP # MEDICARE PART B",
            "identifier": "119133",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OMAP #",
            "identifier": "182824",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukie, OR

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.