Individual provider Active NPI

Kimberly Pontarelli, MOT

  • Occupational Therapist
  • Conroe, TX
National Provider Identifier
1649621491
Registry record updated Oct 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
125391 Issued in TX
Practice address
1803 W White Oak Ter Ste C
Conroe, TX 77304-3675
Phone
(936) 494-1211
NPI assigned
Jun 23, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2025

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 125391 TX Primary

Addresses

Primary practice location

1803 W White Oak Ter Ste C
Conroe, TX 77304-3675

Mailing address

625 Enterprise Dr
Oak Brook, IL 60523-8813
Phone (630) 575-6200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
125391TXMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Select Physical Therapy Texas Limited Partnership PastSince Oct 12, 2025 Accepting new patients
Select Physical Therapy Texas Limited Partnership PastSince Oct 12, 2025 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": "1466640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759708800000",
    "number": "1649621491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 ENTERPRISE DR",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605238813",
            "telephone_number": "630-575-6200",
            "fax_number": "630-928-5040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1803 W WHITE OAK TER STE C",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773043675",
            "telephone_number": "936-494-1211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONTARELLI",
        "first_name": "KIMBERLY",
        "credential": "MOT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-23",
        "last_updated": "2025-10-06",
        "certification_date": "2025-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "125391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conroe, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 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.