Individual provider Active NPI

Tara A Otis, OTR/L, CHT

  • Occupational Therapist
  • Omaha, NE
National Provider Identifier
1629269568
Registry record updated Oct 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
611 Issued in NE
Practice address
2725 S 144TH St Ste 212
Omaha, NE 68144-5253
Phone
(402) 609-3000
Fax
(402) 609-3808
NPI assigned
Aug 6, 2007
Last updated
Oct 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 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 611 NE Primary

Addresses

Primary practice location

2725 S 144TH St Ste 212
Omaha, NE 68144-5253

Mailing address

2725 S 144TH St Ste 212
Omaha, NE 68144-5253
Phone (402) 609-3000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address onclinic@orthonebraska.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, IA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20201208002598 NE Practitioner - Occupational Therapist in Private Practice 0941612337 Reassigns benefits to 1 organization
I20260220000540 IA Practitioner - Occupational Therapist in Private Practice 0941612337 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1988
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2725 S 144TH St
Suite 212
Omaha, NE 68144-5253

450 Regency Pkwy
Suite 310
Omaha, NE 68114-3701

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
00865IAMDPsychologist
611NEMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nebraska Orthopaedic Hospital LLC Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/efffdd49-80a8-4c46-87e6-e53d54707ef3/

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1186358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729555200000",
    "number": "1629269568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2725 S 144TH ST STE 212",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681445253",
            "telephone_number": "402-609-3000",
            "fax_number": "402-609-3808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2725 S 144TH ST STE 212",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681445253",
            "telephone_number": "402-609-3000",
            "fax_number": "402-609-3808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTIS",
        "first_name": "TARA",
        "middle_name": "A",
        "credential": "OTR/L, CHT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-06",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NE",
            "license": "611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "onclinic@orthonebraska.cernerdirect.com",
            "affiliation": "N",
            "address_1": "2725 S 144th St Ste 212",
            "city": "Omaha",
            "state": "NE",
            "country_code": "US",
            "postal_code": "681445253",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2024; 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.