Individual provider Active NPI

Kassandra Elaine Tanana, OTR/L

  • Occupational Therapist
  • Livonia, MI
National Provider Identifier
1700769320
Registry record updated Jul 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
534840 Issued in MI
Practice address
33111 Plymouth Rd
Livonia, MI 48150-1718
Phone
(313) 263-6250
NPI assigned
Jul 30, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2025

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 534840 MI Primary

Addresses

Primary practice location

33111 Plymouth Rd
Livonia, MI 48150-1718

Mailing address

33111 Plymouth Rd
Livonia, MI 48150-1718

Other practice location 1

7007 Dexter Ann Arbor Rd Ste A
Dexter, MI 48130-8568
Phone (734) 680-8800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250828002104 MI Practitioner - Occupational Therapist in Private Practice 1759882103 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Boston, MA 02241

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
534840MIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ivyrehab Michigan, LLC Occupational Therapist CurrentSince Aug 18, 2025 Accepting new patients

Locations

7007 Dexter Ann Arbor Rd
Ste A
Dexter, MI 48130
Phone (734) 680-8800

33111 Plymouth Rd
Livonia, MI 48150
Phone (248) 304-7027

135 S Milford Rd
Milford, MI 48381
Phone (248) 685-7272

1764 S Ortonville Rd
Ste 400
Ortonville, MI 48462
Phone (248) 793-5730

11488 Telegraph Rd
Ste 1
Taylor, MI 48180
Phone (734) 680-8077

1434 W Chicago Blvd
Ste A
Tecumseh, MI 49286
Phone (517) 507-5555

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": "1753833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753833600000",
    "number": "1700769320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33111 PLYMOUTH RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481501718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33111 PLYMOUTH RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481501718",
            "telephone_number": "313-263-6250"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7007 Dexter Ann Arbor Rd Ste A",
            "address_purpose": "LOCATION",
            "city": "Dexter",
            "state": "MI",
            "postal_code": "481308568",
            "country_code": "US",
            "telephone_number": "734-680-8800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TANANA",
        "first_name": "KASSANDRA",
        "middle_name": "ELAINE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-30",
        "last_updated": "2025-07-30",
        "certification_date": "2025-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "534840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 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.