Individual provider Active NPI

Brandon Rosenberg, OTR L

  • Occupational Therapist
  • Queen Creek, AZ
National Provider Identifier
1700086964
Registry record updated Jun 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
3949 Issued in AZ
Practice address
1301 E Debbie Dr
Queen Creek, AZ 85240-4003
Phone
(269) 352-4365
NPI assigned
Jul 24, 2007
Last updated
Jun 22, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 22, 2009

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 3949 AZ Primary

Addresses

Primary practice location

1301 E Debbie Dr
Queen Creek, AZ 85240-4003

Mailing address

1301 E Debbie Dr
Queen Creek, AZ 85240-4003
Phone (269) 352-4365

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191014003575 AZ Practitioner - Occupational Therapist in Private Practice 5698006153

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Stepping Stones Pediatric Therapy, LLC CurrentSince Sep 5, 2019 Accepting new patients

Locations

1505 N Alma School Rd
Ste 2
Chandler, AZ 85224
Phone (480) 626-4142

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1185235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245628800000",
    "number": "1700086964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 E DEBBIE DR",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "852404003",
            "telephone_number": "269-352-4365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 E DEBBIE DR",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "852404003",
            "telephone_number": "269-352-4365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENBERG",
        "first_name": "BRANDON",
        "credential": "OTR L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-24",
        "last_updated": "2009-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AZ",
            "license": "3949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Queen Creek, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2009; 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.