Individual provider Active NPI

Brenda De la Cruz Goldman, OTR/L

  • Occupational Therapist
  • Oklahoma City, OK
National Provider Identifier
1841476058
Registry record updated Jan 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
1083 Issued in OK
Practice address
3327 NW 50TH St
Oklahoma City, OK 73112-5627
Phone
(405) 946-7300
NPI assigned
Jan 17, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2008

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 1083 OK Primary

Addresses

Primary practice location

3327 NW 50TH St
Oklahoma City, OK 73112-5627

Mailing address

820 NW 142ND St
Edmond, OK 73013-1961
Phone (405) 412-6697

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121005000394 OK Practitioner - Occupational Therapist in Private Practice 1850540881 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1083OKMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Hospital LLC Current Accepting new patients
Human Performance Center 10 PC Past Accepting new patients

Locations

3100 SW 89th St
Oklahoma City, OK 73159
Phone (405) 602-8100

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": "1200528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200528000000",
    "number": "1841476058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 NW 142ND ST",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730131961",
            "telephone_number": "405-412-6697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3327 NW 50TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731125627",
            "telephone_number": "405-946-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LA CRUZ GOLDMAN",
        "first_name": "BRENDA",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-17",
        "last_updated": "2008-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OK",
            "license": "1083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2008; 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.