Individual provider Active NPI

Andrea Rose Gurga, OTD, OTR/L

  • Occupational Therapist
  • Chicago, IL
National Provider Identifier
1730651761
Registry record updated Mar 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056.012709 Issued in IL
Practice address
310 N Loomis St
Chicago, IL 60607-1147
Phone
(312) 243-8487
NPI assigned
Jan 2, 2019
Last updated
Mar 11, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2022

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 056.012709 IL Primary

Addresses

Primary practice location

310 N Loomis St
Chicago, IL 60607-1147

Mailing address

310 N Loomis St
Chicago, IL 60607-1147
Phone (312) 243-8487

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230905004137 CO Practitioner - Occupational Therapist in Private Practice 8820451065

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
056.012709ILMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Noco Pediatric OT, LLC Occupational Therapist CurrentSince Jul 28, 2023 Accepting new patients
Noco Pediatric OT, LLC Occupational Therapist Current Accepting new patients
Noco Pediatric OT, LLC Occupational Therapist Past Accepting new patients

Locations

1931 65th Ave
Ste C
Greeley, CO 80634
Phone (970) 352-1877

4650 Royal Vista Cir
Ste 100
Windsor, CO 80528
Phone (970) 305-5070

Organizations & group practices 3

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": "1546387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646956800000",
    "number": "1730651761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 N LOOMIS ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606071147",
            "telephone_number": "312-243-8487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 N LOOMIS ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606071147",
            "telephone_number": "312-243-8487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GURGA",
        "first_name": "ANDREA",
        "middle_name": "ROSE",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-02",
        "last_updated": "2022-03-11",
        "certification_date": "2022-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056.012709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2022; 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.