Individual provider Active NPI

Susan Kay Gotaas, PT

  • Physical Therapist
  • El Paso, TX
National Provider Identifier
1881175651
Registry record updated Aug 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1069938 Issued in TX
Practice address
11169 Sean Haggerty Dr
El Paso, TX 79934-3385
Phone
(915) 849-3000
NPI assigned
Aug 28, 2018
Last updated
Aug 28, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1069938 TX Primary

Addresses

Primary practice location

11169 Sean Haggerty Dr
El Paso, TX 79934-3385

Mailing address

521 Willow Glen Dr
El Paso, TX 79922-2240
Phone (915) 526-8501

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1069938TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Powerback Rehabilitation LLC Physical Therapist CurrentSince Jan 21, 2024 Accepting new patients
Powerback Rehabilitation LLC Physical Therapist CurrentSince Jan 21, 2024 Accepting new patients

Locations

7801 N Richland Blvd
North Richlnd Hls, TX 76180
Phone (469) 609-9044

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, 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": "1535414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535414400000",
    "number": "1881175651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 WILLOW GLEN DR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799222240",
            "telephone_number": "915-526-8501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11169 SEAN HAGGERTY DR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799343385",
            "telephone_number": "915-849-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOTAAS",
        "first_name": "SUSAN",
        "middle_name": "KAY",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-28",
        "last_updated": "2018-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1069938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.