Sudarson Gautam, OTR/L

Primary specialty

Physical Rehabilitation Occupational TherapistTaxonomy code 225XP0019X

License

OC016192 Issued in PA

Practice address

446 Old Farm Rd Apt 2
Palmyra, PA 17078-8720

Phone

(717) 813-0115

NPI assigned

Oct 27, 2014

Last updated

Oct 15, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mr. Sudarson Gautam Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Ace Health & Hospice LLC

  • Home Health Agency
  • Hershey, PA
  • NPI 1922775261
  NPD Authorized official

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

{
    "created_epoch": "1414368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760486400000",
    "number": "1619372182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "446 OLD FARM RD",
            "city": "PALMYRA",
            "state": "PA",
            "postal_code": "170788720",
            "telephone_number": "717-813-0115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "446 OLD FARM RD APT 2",
            "city": "PALMYRA",
            "state": "PA",
            "postal_code": "170788720",
            "telephone_number": "717-813-0115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAUTAM",
        "first_name": "SUDARSON",
        "name_prefix": "Mr.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-27",
        "last_updated": "2025-10-15",
        "certification_date": "2025-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "PA",
            "license": "OC016192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUDARSON",
            "last_name": "GAUTAM",
            "prefix": "MR.",
            "credential": "OTR/L",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Debra Fileta
• Jessica Finsterbush
• Dennis James Fitterer, DC
• Kathryn Fritchman
• Debra Anne Gauker, PHARMD
• Theresa Anne Gerst
• Natalie Gilson, PHARMD
• Bruce L Gingrich, D.C.
• Genean Gingrich
• Daphne Good

• Physical Rehabilitation Occupational Therapist in Palmyra, PA
• Providers in Palmyra, PA by specialty
• Physical Rehabilitation Occupational Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2025; 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.