Individual provider Active NPI

Howard Saccomando, OT

  • Occupational Therapist
  • Merrillville, IN
National Provider Identifier
1558765404
Registry record updated Oct 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
31002378A Issued in IN
Practice address
6966 Broadway
Merrillville, IN 46410-3696
Phone
(219) 769-0711
Fax
(219) 769-0719
NPI assigned
Oct 20, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2014

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 31002378A IN Primary

Addresses

Primary practice location

6966 Broadway
Merrillville, IN 46410-3696

Mailing address

6966 Broadway
Merrillville, IN 46410-3696
Phone (219) 769-0711

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
31002378AINMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Genesis Rehab Services LLC CurrentSince Jun 1, 2016 Accepting new patients

Locations

9430 Wicker Ave
Saint John, IN 46373
Phone (219) 558-8068

1534 119th St
Whiting, IN 46394
Phone (219) 659-0630

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": "1413763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414022400000",
    "number": "1558765404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6966 BROADWAY",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464103696",
            "telephone_number": "219-769-0711",
            "fax_number": "219-769-0719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6966 BROADWAY",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464103696",
            "telephone_number": "219-769-0711",
            "fax_number": "219-769-0719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SACCOMANDO",
        "first_name": "HOWARD",
        "credential": "OT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-10-20",
        "last_updated": "2014-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IN",
            "license": "31002378A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merrillville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2014; 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.