Individual provider Active NPI

Karly Grace Gudykunst, OTR

  • Occupational Therapist
  • Oceanside, CA
National Provider Identifier
1659199255
Registry record updated Apr 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
28980 Issued in CA
Practice address
2335 Vista Way
Oceanside, CA 92054-5663
Phone
(760) 547-2666
NPI assigned
Oct 1, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2026

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 28980 CA Primary
Occupational Therapist 225X00000X 0119010664 VA

Addresses

Primary practice location

2335 Vista Way
Oceanside, CA 92054-5663

Mailing address

618 Rodrigues CT
Oceanside, CA 92058-8544
Phone (570) 702-5781

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20251023003272 VA Practitioner - Occupational Therapist in Private Practice 5395233050 Reassigns benefits to 1 organization
I20260522000605 CA Practitioner - Occupational Therapist in Private Practice 5395233050 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MDRS Spine and Sport IncGroup PAC ID 3274446687, 181 clinicians

Practice addresses (Care Compare)

2335 Vista Way
Oceanside, CA 92054-5663
Phone (760) 547-2666

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
28980CAMDOccupational Therapist
0119010664VAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Physiotherapy Associates, Inc. Occupational Therapist CurrentSince Sep 29, 2025 Accepting new patients
Physiotherapy Associates Inc CurrentSince Sep 29, 2025 Accepting new patients
MDRS Spine & Sport, Inc Occupational Therapist PastSince Apr 27, 2026 Accepting new patients
MDRS Spine & Sport, Inc Occupational Therapist PastSince Apr 27, 2026 Accepting new patients

Locations

20925 Professional Plz
Ste 300
Ashburn, VA 20147
Phone (703) 544-7171

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": "1727740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776124800000",
    "number": "1659199255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "618 RODRIGUES CT",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920588544",
            "telephone_number": "570-702-5781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2335 VISTA WAY",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920545663",
            "telephone_number": "760-547-2666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUDYKUNST",
        "first_name": "KARLY",
        "middle_name": "GRACE",
        "name_prefix": "Ms.",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-01",
        "last_updated": "2026-04-14",
        "certification_date": "2026-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "28980",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "VA",
            "license": "0119010664",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oceanside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2026; 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.