Individual provider Active NPI

Elizabeth Bejcek, OTR

  • Occupational Therapist
  • Santa Maria, CA
National Provider Identifier
1750736872
Registry record updated Apr 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT16149 Issued in CA
Practice address
2530 Professional Pkwy
Santa Maria, CA 93455-8200
Phone
(805) 928-4465
Fax
(805) 928-7935
NPI assigned
Apr 26, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 26, 2016

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 OT16149 CA Primary

Addresses

Primary practice location

2530 Professional Pkwy
Santa Maria, CA 93455-8200

Mailing address

2530 Professional Pkwy
Santa Maria, CA 93455-8200
Phone (805) 928-4465

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260512004214 MN Practitioner - Occupational Therapist in Private Practice 8628361854 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2015
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1920 W Potomac Ave
Chicago, IL 60622-3149

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT16149CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Communities Physician Network, Inc. PastSince May 2, 2016 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": "1461628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461628800000",
    "number": "1750736872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2530 PROFESSIONAL PKWY",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934558200",
            "telephone_number": "805-928-4465",
            "fax_number": "805-928-7935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2530 PROFESSIONAL PKWY",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934558200",
            "telephone_number": "805-928-4465",
            "fax_number": "805-928-7935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEJCEK",
        "first_name": "ELIZABETH",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-26",
        "last_updated": "2016-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "OT16149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Maria, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2016; 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.