Individual provider Active NPI

Nicole Suzanne Kurthausen-Bon, O.T.

  • Hand Occupational Therapist
  • Brentwood, CA
National Provider Identifier
1699118125
Registry record updated Sep 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hand Occupational TherapistTaxonomy code 225XH1200X
License
13350 Issued in CA
Practice address
350 John Muir Pkwy Ste 155
Brentwood, CA 94513-5190
Phone
(925) 939-8585
NPI assigned
Apr 15, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2020

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 13350 CA
Hand Occupational Therapist 225XH1200X 13350 CA Primary

Addresses

Primary practice location

350 John Muir Pkwy Ste 155
Brentwood, CA 94513-5190

Mailing address

PO Box 31396
Walnut Creek, CA 94598-8396
Phone (925) 939-8585

Other identifiers 1

IdentifierTypeStateIssuer
13350OtherCAMEDICAL LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140221001187 CA Practitioner - Occupational Therapist in Private Practice 2264662055 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

350 John Muir Pkwy
Suite 100
Brentwood, CA 94513-5184
Phone (925) 939-8585

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Golden State Orthopedics & Spine CurrentSince Apr 17, 2017 Accepting new patients
Golden State Orthopedics & Spine CurrentSince Apr 17, 2017 Accepting new patients
Golden State Orthopedics & Spine Past Accepting new patients

Locations

350 John Muir Pkwy
Ste 155
Brentwood, CA 94513

101 Sand Creek Rd
#A
Brentwood, CA 94513
Phone (925) 978-6959

350 John Muir Pkwy
Ste 100
Brentwood, CA 94513
Phone (925) 513-2483

5201 Norris Canyon Rd
Ste 230
San Ramon, CA 94583
Phone (925) 244-9355

2625 Shadelands Dr
Walnut Creek, CA 94598
Phone (925) 210-8500

2405 Shadelands Dr
Walnut Creek, CA 94598
Phone (615) 930-0820

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": "1365984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601337600000",
    "number": "1699118125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31396",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945988396",
            "telephone_number": "925-939-8585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 JOHN MUIR PKWY STE 155",
            "city": "BRENTWOOD",
            "state": "CA",
            "postal_code": "945135190",
            "telephone_number": "925-939-8585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KURTHAUSEN-BON",
        "first_name": "NICOLE",
        "middle_name": "SUZANNE",
        "credential": "O.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-15",
        "last_updated": "2020-09-29",
        "certification_date": "2020-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "13350",
            "primary": false
        },
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "CA",
            "license": "13350",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "13350",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brentwood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2020; 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.