Individual provider Active NPI

Katelyn Marie Pagano, OTR

  • Occupational Therapist
  • Garberville, CA
National Provider Identifier
1679319792
Registry record updated Jul 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
19091 Issued in CA
Practice address
733 Cedar St
Garberville, CA 95542-3201
Phone
(707) 923-3921
NPI assigned
Jul 8, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2024

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 19091 CA Primary

Addresses

Primary practice location

733 Cedar St
Garberville, CA 95542-3201

Mailing address

PO Box 1924
Redway, CA 95560-1924
Phone (609) 649-2936

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241223002225 CA Practitioner - Occupational Therapist in Private Practice 0244767770 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Humboldt Community Healthcare District Current Accepting new patients
Southern Humboldt Community Healthcare District CurrentSince Oct 20, 2024 Accepting new patients
Southern Humboldt Community Healthcare District CurrentSince Oct 20, 2024 Accepting new patients

Locations

509 Elm St
Garberville, CA 95542
Phone (707) 463-2400

733 Cedar St
Garberville, CA 95542
Phone (707) 923-3921

Organizations & group practices 3

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": "1720396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720396800000",
    "number": "1679319792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1924",
            "city": "REDWAY",
            "state": "CA",
            "postal_code": "955601924",
            "telephone_number": "609-649-2936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "733 CEDAR ST",
            "city": "GARBERVILLE",
            "state": "CA",
            "postal_code": "955423201",
            "telephone_number": "707-923-3921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAGANO",
        "first_name": "KATELYN",
        "middle_name": "MARIE",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-08",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "19091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garberville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.