Individual provider Active NPI

Joan Maria Kasdagly, OTA

  • Occupational Therapy Assistant
  • Lauderhill, FL
National Provider Identifier
1700654530
Registry record updated Dec 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA15105 Issued in FL
Practice address
5500 NW 69TH Ave Apt 115
Lauderhill, FL 33319-7267
Phone
(954) 440-2696
Fax
(954) 533-4841
NPI assigned
Dec 12, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OTA15105 FL Primary

Addresses

Primary practice location

5500 NW 69TH Ave Apt 115
Lauderhill, FL 33319-7267

Mailing address

1598 SW 191St Ter
Pembroke Pines, FL 33029-6162
Phone (954) 298-4030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
OTA15105FLMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Elite Therapeutic Care, LLC PastSince Dec 17, 2023 Accepting new patients
Flaco Holdings Inc PastSince Dec 17, 2023 Accepting new patients

Organizations & group practices 2

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": "1702339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702339200000",
    "number": "1700654530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1598 SW 191ST TER",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330296162",
            "telephone_number": "954-298-4030",
            "fax_number": "954-533-4841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 NW 69TH AVE APT 115",
            "city": "LAUDERHILL",
            "state": "FL",
            "postal_code": "333197267",
            "telephone_number": "954-440-2696",
            "fax_number": "954-533-4841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASDAGLY",
        "first_name": "JOAN",
        "middle_name": "MARIA",
        "credential": "OTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-12",
        "last_updated": "2023-12-12",
        "certification_date": "2023-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "FL",
            "license": "OTA15105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lauderhill, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.