Individual provider Active NPI

Cristine A Platts, OT

  • Occupational Therapist
  • Beloit, WI
National Provider Identifier
1659316040
Registry record updated Jun 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
2822-26 Issued in WI
Practice address
2825 Prairie Ave
Beloit, WI 53511-1844
Phone
(608) 363-5500
Fax
(608) 363-5539
NPI assigned
Jun 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2013

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 2822-26 WI Primary

Addresses

Primary practice location

2825 Prairie Ave
Beloit, WI 53511-1844

Mailing address

2825 Prairie Ave
Beloit, WI 53511-1844
Phone (608) 363-5500

Other identifiers 2

IdentifierTypeStateIssuer
40788500MedicaidWI
1659316040MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050907000582 WI Practitioner - Occupational Therapist in Private Practice 9830121268 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health System CorporationGroup PAC ID 7416860440, 749 clinicians

Practice addresses (Care Compare)

2825 Prairie Ave
Beloit, WI 53511-1844
Phone (608) 363-5500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2822WIMDRegistered Dietitian
2822-26WIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health System Corporation Occupational Therapist Current Accepting new patients
Mercy Health System Corporation CurrentSince Jan 1, 2006 Accepting new patients
Mercy Health System Corporation Occupational Therapist CurrentSince Jan 1, 2006 Accepting new patients
Mercy Health System Corporation PastSince Jan 1, 2006 Accepting new patients

Locations

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

557 N Washington St
Janesville, WI 53548
Phone (608) 754-6000

1000 Mineral Point Ave
Janesville, WI 53548
Phone (608) 261-6868

Interoperability endpoints

  • Direct secure messaging: cplatts972@direct.mhemail.org

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": "1150588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371427200000",
    "number": "1659316040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2825 PRAIRIE AVE",
            "city": "BELOIT",
            "state": "WI",
            "postal_code": "535111844",
            "telephone_number": "608-363-5500",
            "fax_number": "608-363-5539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2825 PRAIRIE AVE",
            "city": "BELOIT",
            "state": "WI",
            "postal_code": "535111844",
            "telephone_number": "608-363-5500",
            "fax_number": "608-363-5539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLATTS",
        "first_name": "CRISTINE",
        "middle_name": "A",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-18",
        "last_updated": "2013-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "2822-26",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40788500",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1659316040",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beloit, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2013; 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.