Individual provider Active NPI

Susan Jean Patenaude, OTR/L

  • Occupational Therapist
  • Seminole, FL
National Provider Identifier
1467612028
Registry record updated Jun 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT 1995 Issued in FL
Practice address
9449 122ND Way
Seminole, FL 33772-2029
Phone
(727) 459-5544
NPI assigned
Jun 16, 2008
Last updated
Jun 16, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2008

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 OT 1995 FL Primary

Addresses

Primary practice location

9449 122ND Way
Seminole, FL 33772-2029

Mailing address

9449 122ND Way
Seminole, FL 33772-2029
Phone (727) 459-5544

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091214000071 FL Practitioner - Occupational Therapist in Private Practice 5991845547 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

13810 Sheldon Rd
Tampa, FL 33626-3619
Phone (813) 820-5908

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT 1995FLMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
OT Rehab Solutions LLC Occupational Therapist CurrentSince Dec 1, 2009 Accepting new patients
Healthpro Heritage Rehab & Fitness, LLC Occupational Therapist CurrentSince Jan 3, 2023 Accepting new patients
Healthpro Heritage Rehab & Fitness, LLC Occupational Therapist CurrentSince Jan 3, 2023 Accepting new patients
Rehabcare Group East, LLC Past Accepting new patients

Locations

250 Avenue K SW
Winter Haven, FL 33880
Phone (813) 541-8760

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": "1213574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213574400000",
    "number": "1467612028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9449 122ND WAY",
            "city": "SEMINOLE",
            "state": "FL",
            "postal_code": "337722029",
            "telephone_number": "727-459-5544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9449 122ND WAY",
            "city": "SEMINOLE",
            "state": "FL",
            "postal_code": "337722029",
            "telephone_number": "727-459-5544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATENAUDE",
        "first_name": "SUSAN",
        "middle_name": "JEAN",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-16",
        "last_updated": "2008-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT 1995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seminole, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2008; 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.