Individual provider Active NPI

Heather Marie Crandell, OTR

  • Occupational Therapist
  • Madison, WI
National Provider Identifier
1689726432
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
4409-026 Issued in WI
Practice address
2620 Waunona Way
Madison, WI 53713-1525
Phone
(608) 223-1452
NPI assigned
Jan 18, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 4409-026 WI Primary

Addresses

Primary practice location

2620 Waunona Way
Madison, WI 53713-1525

Mailing address

200 Prairie Heights Drive
Apt 102
Verona, WI 53593
Phone (608) 335-2985

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160419002617 WI Practitioner - Occupational Therapist in Private Practice 3779881008 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
University of Wisconsin School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Group Health Cooperative of South Central WisconsinGroup PAC ID 3870489586, 233 clinicians

Practice addresses (Care Compare)

675 W Washington Ave
Madison, WI 53703-2637
Phone (608) 257-9700

Merit-based Incentive Payment System (MIPS)

Final score
82.21 of 100Reported as group
Quality
71.09
Promoting interoperability
99
Improvement activities
40
Cost
70.44

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4409-026WIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Group Health Cooperative of South Central Wisconsin CurrentSince Nov 9, 2015 Accepting new patients

Locations

8054 Watts Rd
Madison, WI 53719
Phone (608) 662-5060

8202 Excelsior Dr
Madison, WI 53717
Phone (608) 831-1766

675 W Washington Ave
Madison, WI 53703
Phone (608) 257-5178

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": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689726432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 PRAIRIE HEIGHTS DRIVE",
            "address_2": "APT 102",
            "city": "VERONA",
            "state": "WI",
            "postal_code": "53593",
            "telephone_number": "608-335-2985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 WAUNONA WAY",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537131525",
            "telephone_number": "608-223-1452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRANDELL",
        "first_name": "HEATHER",
        "middle_name": "MARIE",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "4409-026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.