Tammy Van Gorder

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Practice address

4646 Fairport Nine Mile PT Rd
Fairport, NY 14450-1163

Phone

(585) 377-0350

NPI assigned

Oct 19, 2021

Last updated

Oct 19, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Onr National Speech Pathology IncGroup PAC ID 2668463522, 61 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Onr National Speech Pathology Inc

  dba ONR National, Inc.

  • Rehabilitation Clinic/Center
  • Kensington, MD
  • NPI 1972965952

  NY

  Medicare reassignment Care Compare group NPD
• Select PT, OT & SLP Rehabilitation Ny PLLC

  • Rehabilitation Clinic/Center
  • Jamesville, NY
  • NPI 1457026353
  Medicare reassignment NPD

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

{
    "created_epoch": "1634601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634601600000",
    "number": "1609539436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 VANDERBERG DR",
            "city": "FAIRPORT",
            "state": "NY",
            "postal_code": "144508427",
            "telephone_number": "315-783-7896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4646 FAIRPORT NINE MILE PT RD",
            "city": "FAIRPORT",
            "state": "NY",
            "postal_code": "144501163",
            "telephone_number": "585-377-0350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN GORDER",
        "first_name": "TAMMY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-19",
        "last_updated": "2021-10-19",
        "certification_date": "2021-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zach Valincourt
• Rasheda Valleriani, LMSW
• Maureen Hartigan Vallone, RPH
• Constance Rose Valois, OTR
• Chad Van Gorder, LMSW
• Shannon Lindsay Vankerkhove, OTR/L
• Katherine Marie Vaughn, M.S., R.D., C.D.N
• Erica R Vera, LMSW
• Nicholas John Vergari, PHARMD
• Bridget Viens

• Occupational Therapist in Fairport, NY
• Providers in Fairport, NY by specialty
• Occupational Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2021; 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.