Individual provider Active NPI

Alyssa Brianne Rousseau, OTD, OTR/L

  • Pediatric Occupational Therapist
  • Beatrice, NE
National Provider Identifier
1508419904
Registry record updated Jul 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
2357 Issued in NE
Practice address
900 W Court St
Beatrice, NE 68310-3526
Phone
(402) 223-5277
NPI assigned
Jul 24, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 2357 NE
Pediatric Occupational Therapist 225XP0200X 2357 NE Primary

Addresses

Primary practice location

900 W Court St
Beatrice, NE 68310-3526

Mailing address

3248 Starr St
Lincoln, NE 68503-1997
Phone (402) 525-2791

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
2357NEMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Educational Service Unit #5 CurrentSince Jan 26, 2022 Accepting new patients

Locations

900 W Court St
Beatrice, NE 68310
Phone (402) 223-5277

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": "1563926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563926400000",
    "number": "1508419904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3248 STARR ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685031997",
            "telephone_number": "402-525-2791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 W COURT ST",
            "city": "BEATRICE",
            "state": "NE",
            "postal_code": "683103526",
            "telephone_number": "402-223-5277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUSSEAU",
        "first_name": "ALYSSA",
        "middle_name": "BRIANNE",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-24",
        "last_updated": "2019-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NE",
            "license": "2357",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NE",
            "license": "2357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beatrice, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2019; 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.