Individual provider Active NPI

Elizabeth Ji Ting Goo, OTD, OTR/L

  • Occupational Therapist
  • Jamaica Plain, MA
National Provider Identifier
1467965715
Registry record updated Dec 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
12385 Issued in MA
Practice address
555 Amory St
Jamaica Plain, MA 02130-2652
Phone
(617) 383-6522
NPI assigned
Nov 8, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2024

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 12385 MA Primary

Addresses

Primary practice location

555 Amory St
Jamaica Plain, MA 02130-2652

Mailing address

555 Amory St
Jamaica Plain, MA 02130-2652
Phone (617) 383-6522

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
12385MAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ota the Koomar Center, LLC PastSince Mar 7, 2021 Accepting new patients
Occupational Therapy Associates - Watertown, Inc. PastSince Feb 25, 2024 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1510099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733875200000",
    "number": "1467965715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 AMORY ST",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021302652",
            "telephone_number": "617-383-6522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 AMORY ST",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021302652",
            "telephone_number": "617-383-6522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOO",
        "first_name": "ELIZABETH",
        "middle_name": "JI TING",
        "name_prefix": "Dr.",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-08",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MA",
            "license": "12385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica Plain, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.