Individual provider Active NPI

Rebecca M Blandina, OT

  • Occupational Therapist
  • Belleville, IL
National Provider Identifier
1437283595
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Practice address
2810 Frank Scott Pkwy W
Ste. 824
Belleville, IL 62223-5007
Phone
(618) 234-9705
Fax
(618) 257-0665
NPI assigned
Mar 14, 2007
Last updated
Jul 8, 2007By the provider in NPPES
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 IL Primary

Addresses

Primary practice location

2810 Frank Scott Pkwy W
Ste. 824
Belleville, IL 62223-5007

Mailing address

2810 Frank Scott Pkwy W
Ste. 824
Belleville, IL 62223-5007
Phone (618) 234-9705

Other names 1

  • Rebecca M Lysaker Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190412001763 IL Practitioner - Occupational Therapist in Private Practice 0345581666 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Comprehensive Therapeutics LTDGroup PAC ID 8921230137, 324 clinicians

Practice addresses (Care Compare)

1015 Oconor Ave
La Salle, IL 61301-1216
Phone (224) 616-5446

1145 Arbor Dr
Decatur, IL 62526-9347
Phone (217) 247-7509

202 N Show Place Dr
Rockford, IL 61107-5351
Phone (815) 860-0788

3900 Sullivan Dr
Swansea, IL 62226-7397
Phone (618) 243-3598

5500 46TH Ave Dr
Moline, IL 61265-9760
Phone (309) 249-8807

6960 State Route 162
Maryville, IL 62062-8522
Phone (618) 243-3596

844 Cambridge Blvd
O Fallon, IL 62269-1976
Phone (618) 242-3742

875 W McKinley Ave
Decatur, IL 62526-3287
Phone (217) 615-2523

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
056007276ILMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Therapeutics LTD Occupational Therapist CurrentSince Nov 29, 2018 Accepting new patients
Comprehensive Therapeutics LTD Occupational Therapist CurrentSince Nov 29, 2018 Accepting new patients

Locations

1015 Oconor Ave
La Salle, IL 61301
Phone (224) 616-5446

536 Old Howell Rd
Greenville, SC 29615
Phone (877) 508-3237

Organizations & group practices 2

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": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1437283595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2810 FRANK SCOTT PKWY W",
            "address_2": "STE. 824",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622235007",
            "telephone_number": "618-234-9705",
            "fax_number": "618-257-0665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2810 FRANK SCOTT PKWY W",
            "address_2": "STE. 824",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622235007",
            "telephone_number": "618-234-9705",
            "fax_number": "618-257-0665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANDINA",
        "first_name": "REBECCA",
        "middle_name": "M",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "LYSAKER",
            "middle_name": "M",
            "credential": "OT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Belleville, IL

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.
  • 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.