Individual provider Active NPI

Kristine Elizabeth Tolbert

  • Occupational Therapist
  • Palo Alto, CA
National Provider Identifier
1821618992
Registry record updated May 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
4410 Issued in CA
Practice address
1053 Maddux Dr
Palo Alto, CA 94303-4013
Phone
(650) 303-8586
NPI assigned
Apr 20, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2020

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 4410 CA Primary

Addresses

Primary practice location

1053 Maddux Dr
Palo Alto, CA 94303-4013

Mailing address

1053 Maddux Dr
Palo Alto, CA 94303-4013
Phone (650) 303-8586

Other identifiers 1

IdentifierTypeStateIssuer
6231OtherCABLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221007002444 CA Practitioner - Occupational Therapist in Private Practice 2769868124 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Indiana University School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hands-on-CareGroup PAC ID 3971682311, 5 clinicians

Practice addresses (Care Compare)

3395 S Bascom Ave
Suite 100
Campbell, CA 95008-6770
Phone (408) 884-8361

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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": "1587340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589328000000",
    "number": "1821618992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1053 MADDUX DR",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943034013",
            "telephone_number": "650-303-8586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1053 MADDUX DR",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943034013",
            "telephone_number": "650-303-8586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOLBERT",
        "first_name": "KRISTINE",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-20",
        "last_updated": "2020-05-13",
        "certification_date": "2020-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "4410",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "6231",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palo Alto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2020; 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.