Individual provider Active NPI

Elliott Brent

  • Occupational Therapist
  • Sacramento, CA
National Provider Identifier
1457839029
Registry record updated Aug 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT14583 Issued in CA
Practice address
5350 Madison Ave
Sacramento, CA 95841-3169
Phone
(916) 677-0008
NPI assigned
Aug 5, 2018
Last updated
Aug 5, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2018

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 OT14583 CA Primary

Addresses

Primary practice location

5350 Madison Ave
Sacramento, CA 95841-3169

Mailing address

5350 Madison Ave
Sacramento, CA 95841-3169

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190709002719 CA Practitioner - Occupational Therapist in Private Practice 7113252446 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2014
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1759 Tudor Way
Plumas Lake, CA 95961-8952

1920 W Potomac Ave
Chicago, IL 60622-3149

7 Clyde Rd
Somerset, NJ 08873-5049

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14583CAMDDental Hygienist
OT14583CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
S.a.C. Physical Therapy, P.C. Multi-Specialty CurrentSince Jun 20, 2024 Accepting new patients
CRS Physical Therapy Inc. Multi-Specialty CurrentSince Dec 31, 2025 Accepting new patients
Therapy in Your Home - OT, PT, St Multi-Specialty CurrentSince Apr 13, 2019 Accepting new patients
Fox Rehabilitation Physical Therapy Ca PC Multi-Specialty CurrentSince Jun 1, 2025 Accepting new patients
Good Health Medical Inc Multi-Specialty PastSince Nov 18, 2025 Accepting new patients
West Coast Medical Care Professional Corporation Multi-Specialty PastSince Apr 8, 2015 Accepting new patients

Locations

16868 Via del Campo Ct
Ste 100
San Diego, CA 92127
Phone (313) 629-9340

95 Duesenberg Dr
Westlake Village, CA 91362
Phone (805) 413-3300

1103 Butte House Rd
Ste D
Yuba City, CA 95991
Phone (530) 324-8490

Organizations & group practices 6

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": "1533427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533427200000",
    "number": "1457839029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5350 MADISON AVE",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958413169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5350 MADISON AVE",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958413169",
            "telephone_number": "916-677-0008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRENT",
        "first_name": "ELLIOTT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-08-05",
        "last_updated": "2018-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "OT14583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2018; 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.