Individual provider Active NPI

Lisa Vanageatigul, OT

  • Occupational Therapist
  • Las Vegas, NV
National Provider Identifier
1629643945
Registry record updated May 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT-2725 Issued in NV
Practice address
11091 Kilkerran CT
Las Vegas, NV 89141-4356
Phone
(702) 672-4104
NPI assigned
May 20, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2021

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 OT-2725 NV Primary

Addresses

Primary practice location

11091 Kilkerran CT
Las Vegas, NV 89141-4356

Mailing address

7556 Grist Mill CT
Las Vegas, NV 89113-1143
Phone (415) 706-0406

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210803002904 NV Practitioner - Occupational Therapist in Private Practice 8426452186 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tiltons Therapy IncGroup PAC ID 7719219948, 9 clinicians

Practice addresses (Care Compare)

11091 Kilkerran CT
Las Vegas, NV 89141-4356
Phone (702) 381-1839

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT-2725NVMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Tiltons Therapy Inc Occupational Therapist CurrentSince Aug 1, 2021 Accepting new patients
Debbie Tilton Otrl Inc Occupational Therapist Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1621468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621468800000",
    "number": "1629643945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7556 GRIST MILL CT",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891131143",
            "telephone_number": "415-706-0406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11091 KILKERRAN CT",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891414356",
            "telephone_number": "702-672-4104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANAGEATIGUL",
        "first_name": "LISA",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-20",
        "last_updated": "2021-05-20",
        "certification_date": "2021-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NV",
            "license": "OT-2725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 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.