Individual provider Active NPI

Kylie Puggi

  • Occupational Therapist
  • Elk Grove, CA
National Provider Identifier
1629641808
Registry record updated Jan 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
23574 Issued in CA
Practice address
9281 Office Park Cir Ste 100
Elk Grove, CA 95758-8069
Phone
(916) 892-1330
NPI assigned
Jul 23, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2024

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 46TR00976600 NJ
Occupational Therapist 225X00000X 23574 CA Primary

Addresses

Primary practice location

9281 Office Park Cir Ste 100
Elk Grove, CA 95758-8069

Mailing address

9281 Office Park Cir Ste 100
Elk Grove, CA 95758-8069
Phone (916) 892-1330

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230105001029 CA Practitioner - Occupational Therapist in Private Practice 4880091917 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2018
Medicare assignment
May accept Medicare assignment
Group practices
Select Cal Physical Therapy PCGroup PAC ID 4789070699, 162 clinicians

Practice addresses (Care Compare)

9281 Office Park Cir
Suite 100
Elk Grove, CA 95758-8069
Phone (916) 892-1330

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Select Cal Physical Therapy PC Occupational Therapist CurrentSince Oct 7, 2022 Accepting new patients
Select Cal Physical Therapy PC CurrentSince Oct 7, 2022 Accepting new patients
Select Cal Physical Therapy PC Occupational Therapist Current Accepting new patients
Rehabclinics SPT Inc PastSince Jul 1, 2021 Accepting new patients

Locations

9281 Office Park Cir
Ste 100
Elk Grove, CA 95758
Phone (916) 892-1330

Organizations & group practices 4

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": "1626998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704758400000",
    "number": "1629641808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9281 OFFICE PARK CIR STE 100",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957588069",
            "telephone_number": "916-892-1330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9281 OFFICE PARK CIR STE 100",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957588069",
            "telephone_number": "916-892-1330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUGGI",
        "first_name": "KYLIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-23",
        "last_updated": "2024-01-09",
        "certification_date": "2024-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NJ",
            "license": "46TR00976600",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "23574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 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.