Individual provider Active NPI

Tudor Panta, OTR

  • Neurorehabilitation Occupational Therapist
  • Louisville, KY
National Provider Identifier
1679383046
Registry record updated Nov 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurorehabilitation Occupational TherapistTaxonomy code 225XN1300X
License
246560 Issued in KY
Practice address
1941 Bishop LN Ste 404
Louisville, KY 40218-1922
Phone
(502) 488-2753
Fax
(502) 308-4725
NPI assigned
Jan 8, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Neurorehabilitation Occupational Therapist 225XN1300X 246560 KY Primary
Occupational Therapist 225X00000X 246560 KY
Hand Occupational Therapist 225XH1200X 246560 KY
Hand Occupational Therapist 225XH1200X 31006869A IN
Physical Rehabilitation Occupational Therapist 225XP0019X 31006869A IN
Neurorehabilitation Occupational Therapist 225XN1300X 31006869A IN
Physical Rehabilitation Occupational Therapist 225XP0019X 246560 KY
Occupational Therapist 225X00000X 31006869A IN

Addresses

Primary practice location

1941 Bishop LN Ste 404
Louisville, KY 40218-1922

Mailing address

1941 Bishop LN Ste 404
Louisville, KY 40218-1922
Phone (502) 488-2753

Other practice location 1

3209 Laclede Ave
New Albany, IN 47150-2332
Phone (317) 658-2194

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, KY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20250321001325 IN Practitioner - Occupational Therapist in Private Practice 9638691421 Reassigns benefits to 1 organization
I20250528000162 KY Practitioner - Occupational Therapist in Private Practice 9638691421 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1941 Bishop LN
Suite 404
Louisville, KY 40218-1922
Phone (502) 488-2753

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
31006869AINMDNeurorehabilitation Occupational Therapist
246560KYMDNeurorehabilitation Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Emerge TX LLC Neurorehabilitation CurrentSince Jan 23, 2025 Accepting new patients

Locations

5534 Saint Joe Rd
Fort Wayne, IN 46835
Phone (423) 502-1508

1941 Bishop Ln
Ste 404
Louisville, KY 40218
Phone (502) 488-2753

225 N Clifton Ave
Ste 5
Louisville, KY 40206

Organizations & group practices 1

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": "1736294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762905600000",
    "number": "1679383046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1941 BISHOP LN STE 404",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402181922",
            "telephone_number": "502-488-2753",
            "fax_number": "502-308-4725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1941 BISHOP LN STE 404",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402181922",
            "telephone_number": "502-488-2753",
            "fax_number": "502-308-4725"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3209 Laclede Ave",
            "address_purpose": "LOCATION",
            "city": "New Albany",
            "state": "IN",
            "postal_code": "471502332",
            "country_code": "US",
            "telephone_number": "317-658-2194",
            "fax_number": "502-308-4725",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PANTA",
        "first_name": "TUDOR",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-01-08",
        "last_updated": "2025-11-12",
        "certification_date": "2025-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XN1300X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Neurorehabilitation",
            "state": "KY",
            "license": "246560",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "KY",
            "license": "246560",
            "primary": false
        },
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "KY",
            "license": "246560",
            "primary": false
        },
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "IN",
            "license": "31006869A",
            "primary": false
        },
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "IN",
            "license": "31006869A",
            "primary": false
        },
        {
            "code": "225XN1300X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Neurorehabilitation",
            "state": "IN",
            "license": "31006869A",
            "primary": false
        },
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "KY",
            "license": "246560",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IN",
            "license": "31006869A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2025; 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.