NPIMap

Elijah Q Boston, OTD

Individual provider Active NPI Occupational Therapist · Las Vegas, NV

NPI 1720770795 · NPPES record last updated May 25, 2023

Key facts

NPI
1720770795
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
Practice address
5355 Edmond St Apt 1076
Las Vegas, NV 89118-6059
Phone
(813) 598-7680
NPI assigned
May 25, 2023
Sex
Male
Sole proprietor
No

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.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Frontline Therapy Solutions Occupational Therapist Current
since Jun 16, 2024		 Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Human Factors Occupational Therapist 225XH1300X
Low Vision Occupational Therapist 225XL0004X
Gerontology Occupational Therapist 225XG0600X
Hand Occupational Therapist 225XH1200X
Mental Health Occupational Therapist 225XM0800X
Neurorehabilitation Occupational Therapist 225XN1300X
Environmental Modification Occupational Therapist 225XE0001X
Ergonomics Occupational Therapist 225XE1200X
Feeding, Eating & Swallowing Occupational Therapist 225XF0002X
Pediatric Occupational Therapist 225XP0200X
Occupational Therapist 225X00000X Yes

Addresses

Primary practice location

5355 Edmond St Apt 1076
Las Vegas, NV 89118-6059

Mailing address

5355 Edmond St Apt 1076
Las Vegas, NV 89118-6059
Phone (813) 598-7680

Other providers in Las Vegas, NV

All providers in Las Vegas, NV · Occupational Therapist in Nevada

Sources for this page

Verify at the official NPI Registry.