NPIMap

Individual provider Active NPI

Amber R Kilczewski, OT

  • Pediatric Occupational Therapist
  • Olympia, WA
National Provider Identifier
1710204763
Registry record updated May 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
Practice address
1717 Fir St NE
Olympia, WA 98506-3426
Phone
(360) 259-3620
Fax
(360) 515-0065
NPI assigned
Apr 30, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 25, 2017

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X
Mental Health Occupational Therapist 225XM0800X
Neurorehabilitation Occupational Therapist 225XN1300X
Physical Rehabilitation Occupational Therapist 225XP0019X
Pediatric Occupational Therapist 225XP0200X Primary

Addresses

Primary practice location

1717 Fir St NE
Olympia, WA 98506-3426

Mailing address

1717 Fir St NE
Olympia, WA 98506-3426
Phone (360) 259-3620

Other names 1

  • Amber R Keating Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220217000361 WA Practitioner - Occupational Therapist in Private Practice 8123411063 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System CurrentSince Nov 11, 2021 Accepting new patients
Multicare Health System CurrentSince Nov 11, 2021 Accepting new patients
Multicare Health System Current Accepting new patients
Westbound Speech Therapy PLLC Occupational Therapist Past Accepting new patients

Locations

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

200 Lilly Rd NE
Ste C
Olympia, WA 98506
Phone (360) 918-8336

Organizations & group practices 4

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": "1272585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1495670400000",
    "number": "1710204763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 FIR ST NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985063426",
            "telephone_number": "360-259-3620",
            "fax_number": "360-515-0065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 FIR ST NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985063426",
            "telephone_number": "360-259-3620",
            "fax_number": "360-515-0065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILCZEWSKI",
        "first_name": "AMBER",
        "middle_name": "R",
        "credential": "OT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-30",
        "last_updated": "2017-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XM0800X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XN1300X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Neurorehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMBER",
            "last_name": "KEATING",
            "middle_name": "R",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Olympia, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2017; 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.