Individual provider Active NPI

Zak Gast, OTR

  • Occupational Therapist
  • Warrenville, IL
National Provider Identifier
1457127698
Registry record updated Nov 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
6687-26 Issued in WI
Practice address
28100 Torch Pkwy Ste 600
Warrenville, IL 60555-4030
Phone
(630) 413-5800
NPI assigned
Nov 29, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 29, 2023

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 6687-26 WI Primary

Addresses

Primary practice location

28100 Torch Pkwy Ste 600
Warrenville, IL 60555-4030

Mailing address

834 S 6TH Ave
West Bend, WI 53095-4614
Phone (920) 629-9893

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240325000712 WI Practitioner - Occupational Therapist in Private Practice 2163869397 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fox Rehabilitation Services Wi LLCGroup PAC ID 1658647581, 144 clinicians

Practice addresses (Care Compare)

2130 Continental Dr
West Bend, WI 53095-7904
Phone (262) 338-0092

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6687-26WIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Rehabilitation Services Wi LLC Occupational Therapist CurrentSince Mar 1, 2024 Accepting new patients

Locations

7 Carnegie Plz
Cherry Hill, NJ 08003

Organizations & group practices 1

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": "1701216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701216000000",
    "number": "1457127698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "834 S 6TH AVE",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530954614",
            "telephone_number": "920-629-9893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28100 TORCH PKWY STE 600",
            "city": "WARRENVILLE",
            "state": "IL",
            "postal_code": "605554030",
            "telephone_number": "630-413-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAST",
        "first_name": "ZAK",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-11-29",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "6687-26",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warrenville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2023; 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.